目的探讨涤纶布用于直肠悬吊术治疗直肠脱垂的临床疗效。 方法对采用涤纶布条行直肠骶骨悬吊术治疗直肠脱垂38例患者的临床资料进行回顾性分析。 结果术后除2例切口感染，1例并发尿潴留外，其余35例无任何并发症发生。38例患者均治愈出院，平均住院时间12 d。本组病例均获随访，随访时间1~9年，随访期间无一例复发，均能进行日常体力劳动。结论用涤纶布条行直肠悬吊术治疗直肠脱垂，疗效确切，操作简便，创伤小，值得临床推广。
目的 探讨吻合器痔上黏膜环切术（PPH）的操作技巧、临床疗效及并发症。方法 根据患者具体情况，采用PPH术个性化治疗重度痔病患者128例，分析其手术操作技巧与临床疗效及术中、术后并发症的关系。结果 手术持续时间平均为30min，切除组织宽度平均为3.5cm。术中出血58例，其中渗血42例，搏动性出血16例。术后出血5例，吻合口感染1例；无大便失禁、吻合口狭窄。术后6个月随访，106例外脱痔块完全回缩，7例回缩不全，15例失访。结论 PPH术已被初步证明是一种微创、安全、有效的手术，但尚需进一步的经验积累及大规模临床试验加以验证。
目的 观察经肛门吻合器直肠部分切除吻合术（stapler transanal partial resection of rectum，STAPRE）治疗直肠脱垂的临床疗效。方法 笔者所在医院2005年8月至2011年2月期间对长度小于15cm的42例直肠脱垂患者行STAPRE治疗。结果 术后随访12个月者36例（其中19例超过24个月），随访6个月者6例，均未见复发。结论 STAPRE适合Ⅰ、Ⅱ及Ⅲ度直肠脱垂以及年迈和全身状况不佳的患者，可消除开腹手术带来的风险。
ObjectiveTo explore the effect of laparoscopic partial recto-sigmoid resection with rectopexy for adult complete rectal prolapse. MethodsClinical data of 32 adult patients with complete rectal prolapse who underwent laparoscopic partial recto-sigmoid resection with rectopexy in our hospital from May. 2010 to May. 2013 were analyzed. ResultsAll operations were performed successfully and all patients were cured, no one transferred to open surgery. The mean of operation time was 114.7 min (95-167 min), the mean of operative blood loss was 80 mL (55-150 mL), and the mean of hospital stay was 9.8 d (6-14 d). All patients were followed up for 3-48 months (mean of 25.6 months), and anal function of them recovered well. During the follow-up period, there were no operative complications and recurrent case. ConclusionsLaparoscopic partial recto-sigmoid resection with rectopexy is a safe and effective procedure for the treatment of adult complete rectal prolapse, with minimal invasion, quick recovery, and a low recurrence rate. It provides a novel surgical method with a high value of clinical application.
ObjectiveTo evaluate the application of modified perineal stapled prolapse resection in treatment of external rectal prolapse, and to assess the preliminary efficacy. MethodsClinical data of 11 patients with external rectal prolapse underwent modified perineal stapled prolapse resection in The First Affiliated Hospital of Guangzhou University of Chinese Medicine between December 2013 and August 2015 were collected for retrospectively analysis. ResultsAll patients with external rectal prolapse were performed modified perineal stapled prolapse resection with general anesthesia and (or) epidural anesthesia. The average operation time was (53.6±6.1) min (40-85 min) and the average blood loss was (35.3±10.1) mL (20-60 mL). The time of the first flatus was less than 24 h after operation, the time of the first defecation was (44.6±3.3) h (40-52 h) after operation. The average hospital stay was (9.7±1.8) d (7-12 d) and average cost was (34 635.8±1 268.8) RMB (31 796-36 212 RMB). None of them occurred serious complications such as uncontrollable anastomotic stoma bleeding, anastomotic leakage, pelvic abscess, bowel obstruction, and anastomotic straitness. All of the 11 patients were followed up for (4.7±0.8) months (3-7 months), and all patients did not suffered from recurrence and fecal incontinence during follow-up period. ConclusionsThe essential procedure for modified perineal stapled prolapse resection is cutting the prolapse open at 3 and 9 clock directly at the same time by linear staplers, and dissecting mesorectum before using the contour satpler. Modified perineal stapled prolapse resection is a safe and effective operation technique for the external rectal prolapse.
Objective To evaluate therapeutic effect of tile shape perineal stapled prolapse resection in treatment of rectal prolapse. Methods The clinical data of 31 patients with rectal prolapse underwent tile shape perineal stapled prolapse resection in the Renmin Hospital of Wuhan University from December 2013 to August 2015 were retrospectively analyzed. All the patients with rectal prolapse were performed the tile shape perineal stapled prolapse resection with general anesthesia and (or) epidural anesthesia. The prolapse was completely pulled out and then axially cut open with a linear stapler in the lithotomy position. Finally, the prolapse was resected stepwise with the curved stapler at the prolapse’s uptake. Results There were 8 males and 23 females in the 31 patients. The age was (65.8±3.2) years old. There were 14 patients with Ⅱ degree and 17 patients with Ⅲ degree prolapses. The median course was 5.8 years. The 31 patients were followed up for 0.5–7.0 months. Of 31 cases, the 24 cases were cured and 7 cases were better. It was found out that there was a significant difference between the number of axially cut open with a linear stapler and the weight of specimen (P<0.05). And there was a significant difference between the number of axially cut open with a linear stapler and the recurrence (P<0.05) too. When the number of axially cut open with a linear stapler were 4 for Ⅱ degree and 3 for Ⅲ degree, the treatment had been proved to be the highest efficacy. Conclusions Preliminary results of limited cases in this study show that tile shape perineal stapled prolapse resection is safe and effective in treatment of rectal prolapsed. Key of operation is that prolapse is completely pulled out and then axially cut open with a linear stapler at some o’clock for 2–4 points and rectal valves are formed. Prolapsed is resected stepwise with curved stapler at prolapse’s uptake. When number of axially cut open with a linear stapler are 4 for Ⅱ degree and 3 for Ⅲ degree, it could achieve the best therapeutic effect.