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external rectal prolapse:abdominal or perineal repair for men?A retrospective cohort study

Gastroenterology Report 2022年第1期10卷 277-283页

作者： Bang Hu Qi Zou Zhenyu Xian Dan Su Chao Liu Li Lu Minyi Luo Zixu Chen Keyu Cai Han Gao Hui Peng Wuteng Cao Donglin Ren Department of Colorectal and Anal Surgery The Sixth Affiliated HospitalSun Yat-sen UniversityGuangzhouGuangdongP.R.China Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases Guangdong Institute of GastroenterologyThe Sixth Affiliated HospitalSun Yat-sen UniversityGuangzhouGuangdongP.R.China Department of Digestive Center PanYu Central HospitalGuangzhouGuangdongP.R.China Department of Microbiology Zhongshan School of MedicineKey Laboratory for Tropical Diseases Control of the Ministry of EducationSun Yat-sen UniversityGuangzhouGuangdongP.R.China Department of Radiology The Sixth Affiliated HospitalSun Yat-sen UniversityGuangzhouGuangdongP.R.China

Background:external rectal prolapse is a relatively rare disease,in which male patients account for a *** selection of abdominal repair or perineal repair for male patients has rarely been ***:Fifty-one male patients receiving abdominal repair(laparoscopic ventral rectopexy)or perineal repair(Delorme or Altemeier procedures)at the Sixth Affiliated Hospital of Sun Yat-sen University(Guangzhou,China)between March 2013 and September 2019 were retrospectively *** compared the recurrence,complication rate,post-operative defecation disorder,length of stay,and quality of life between the abdominal and perineal ***:Of the 51 patients,45 had a complete follow-up,with a median of 48.5 months(range,22.8–101.8 months).A total of 35 patients were under age 40 *** complication rate associated with abdominal repair was less than that associated with perineal repair(0%vs 20.7%,P=0.031)and the recurrence rate was also lower(9.5%vs 41.7%,P=0.018).Multivariate analysis showed that perineal repair(odds ratio,9.827;95%confidence interval,1.296–74.50;P=0.027)might be a risk factor for ***,only perineal repair significantly improved post-operative constipation status(preoperative vs post-operative,72.4%vs 25.0%,P=0.001).There was no reported mortality in either of the *** patient’s sexual function was affected by the ***:Both surgical approaches were safe in *** with perineal repair,the complication rate and recurrence rate for abdominal repair were ***,perineal repair was better able to correct constipation.

关键词： external rectal prolapse male laparoscopic ventral rectopexy Altemeier Delorme

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Current status of laparoscopic and robotic ventral mesh rectopexy for external and internal rectal prolapse

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World Journal of Gastroenterology 2016年第21期22卷 4977-4987页

作者： Jan J van Iersel Tim JC Paulides Paul M Verheijen John W Lumley Ivo AMJ Broeders Esther CJ Consten Meander Medical Centre Department of Surgery Twente University Faculty of Science and Technology Institute of Technical Medicine Wesley Medical Centre Department of Surgery

external and internal rectal prolapse with their affiliated rectocele and enterocele, are associated with debilitating symptoms such as obstructed defecation, pelvic pain and faecal incontinence. Since perineal procedures are associated with a higher recurrence rate, an abdominal approach is commonly preferred. Despite the description of greater than three hundred different procedures, thus far no clear superiority of one surgical technique has been demonstrated. Ventral mesh rectopexy(VMR) is a relatively new and promising technique to correct rectal prolapse. In contrast to the abdominal procedures of past decades, VMR avoids posterolateral rectal mobilisation and thereby minimizes the risk of postoperative constipation. Because of a perceived acceptable recurrence rate, good functional results and low mesh-related morbidity in the short to medium term, VMR has been popularized in the past decade. Laparoscopic or robotic-assisted VMR is now being progressively performed internationally and several articles and guidelines propose the procedure as the treatment of choice for rectal prolapse. In this article, an outline of the current status of laparoscopic and robotic ventral mesh rectopexy for the treatment of internal and external rectal prolapse is presented.

关键词： Laparoscopic ventral mesh rectopexy Robot rectal prolapse external rectal prolapse Internal rectal prolapse Rectocele Mesh erosion Obstructed defecation Faecal incontinence Biological mesh

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Stapled Trans-Anal rectal Resection (STARR) for Obstructive Defecation Syndrome—Functional Outcome and Quality of Life after Two Years

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International Journal of Clinical Medicine 2016年第3期7卷 217-224页

作者： Mike Ralf Langenbach Alexandre Berengolts Helios St. Elisabeth Klinik Oberhausen Department of Surgery II University of Witten/Herdecke Oberhausen Germany

Background: Stapled transanal rectal resection (STARR) has been shown to improve patients’ functional and quality of life outcomes in several studies. Although it is a safe and effective treatment for obstructive defecation syndrome, still data on long-term follow-up are missing. Methods: From January 2010 to July 2014, 46 consecutive patients undergoing STARR using the CONTOUR® TRANSTAR™ device, shortly named TRANSTAR (transanal stapler assisted resection), were prospectively followed. Recurrence rate, quality of life (Patient Assessment of Constipation-Quality of Life (PAC-Qol)) and complication were documented at baseline, 12 and 24 months after operation. Two subgroups of patients were compared to assess the impact of resection length on outcome. Results: We included 46 patients (89% female) in the study. The mean age was 65 ± 16 years and the duration of the operation was 48 ± 4 min. Total PAC-QoL score improved from 2.0 (SD 0.3) to 0.9 (1.4) after 12 months, but deteriorated to 1.2 (0.3) after 24 months (p prolapse recurrence and after 24 month we had another. There was no significant relation between the length of the specimen and the improvement of life quality. Conclusions: The STARR procedure seems to be a safe and fast therapeutic option for patients with ODS and/or rectal prolapse. It is a tailored transanal full-thickness rectal resection improving the patients’ quality of life still two years after the operation.

关键词： STARR Obstructive Defecation Syndrome external rectal prolapse Transanal Approach Constipation

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