【摘要翻译】治疗完全性直肠脱垂的Delorme手术和Orr-Loygue直肠固定术的长期效果
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Long-term results of Delorme’s procedure and Orr-Loygue rectopexy to treat complete rectal prolapse
MarchalF./Bresler L./AyavA. et al. DIS. COLONRECTUM 2005, 48/9 (1785-1790)
PURPOSE: The aim of this study was to assess long-term outcome of Orr-Loygue rectopexy and Delorme’s procedures in total rectal prolapse management. METHODS: Data were collected retrospectively from 1978 to 2001. Statistical analysis was performed by chi-squared test and Student’s t -test. RESULTS: One hundred nine patients underwent either a Orr-Loygue rectopexy (49 patients) or a Delorme’s procedure (60 patients). Mean follow-up was 88 (range, 1-300) months. In the rectopexy group, the overall complication rate and the recurrence rate were 33 percent and 4 percent, respectively. In patients with preoperative constipation, this symptom was improved or completely resolved in 33 percent and worsenedin 58 percent postoperatively. Seventy-three percent of patients with preoperative incontinence were continent or had continence improvement postoperatively. In Delorme’s group, overall complication and recurrence rates were 15 percent and 23 percent, respectively. Mortality was 7 percent. In patients with preoperative constipation, this symtom was improved or completely resolved in 54 percent and worsened in 12.5 percent of patients postoperatively. Forty-two percent of patients with preoperative incontinence were continent or had continence improvement postoperatively. CONCLUSIONS: In this study, Orr-Loygue rectopexy had a lower long-term recurrence rate. However, this surgical procedure is associated with a higher complication rate. We believe that Delorme’s procedure is still a valuable option in selected patients with postoperative minimal morbidity but higher recurrence rate.
治疗完全性直肠脱垂的Delorme手术和Orr-Loygue直肠固定术的长期效果
目的
：本研究目的是评估处置完全性直肠脱垂的Orr-Loygue直肠固定术和Delorme手术（肛门直肠粘膜剔除和直肠肌层折叠术）的长期结果。方法：回顾性收集1978~2001年间的有关资料。统计学分析采用卡方检验和Student’s t 检验。结果：109例患者接受了Orr-Loygue直肠固定术（49例）或Delorme手术（60例）。平均随访时间为88个月（1~300个月）。在直肠固定术组，总的并发症发生率和复发率分别为33%和4%；在术前便秘的患者中，33%术后症状得到改善或完全缓解，58%术后症状加重；在术前大便失禁的患者中，73%术后大便可以控制或大便控制得到改善。在Delorme手术组，总的并发症发生率和复发率分别为15%和23%；术后死亡率为7%；在术前便秘的患者中，54%术后症状得到改善或完全缓解，12.5%术后症状加重；在术前大便失禁的患者中，42%术后大便可以控制或大便控制得到改善。结论：在本研究中，Orr-Loygue直肠固定术的长期术后复发率更低，但该术式的并发症发生率更高（与Delorme手术比较）。我们认为，Delorme手术术后并发症发生率很低，而术后复发率相对较高，挑选合适的直肠脱垂患者选择Delorme手术仍具有价值。
MarchalF./Bresler L./AyavA. et al. DIS. COLONRECTUM 2005, 48/9 (1785-1790)
PURPOSE: The aim of this study was to assess long-term outcome of Orr-Loygue rectopexy and Delorme’s procedures in total rectal prolapse management. METHODS: Data were collected retrospectively from 1978 to 2001. Statistical analysis was performed by chi-squared test and Student’s t -test. RESULTS: One hundred nine patients underwent either a Orr-Loygue rectopexy (49 patients) or a Delorme’s procedure (60 patients). Mean follow-up was 88 (range, 1-300) months. In the rectopexy group, the overall complication rate and the recurrence rate were 33 percent and 4 percent, respectively. In patients with preoperative constipation, this symptom was improved or completely resolved in 33 percent and worsenedin 58 percent postoperatively. Seventy-three percent of patients with preoperative incontinence were continent or had continence improvement postoperatively. In Delorme’s group, overall complication and recurrence rates were 15 percent and 23 percent, respectively. Mortality was 7 percent. In patients with preoperative constipation, this symtom was improved or completely resolved in 54 percent and worsened in 12.5 percent of patients postoperatively. Forty-two percent of patients with preoperative incontinence were continent or had continence improvement postoperatively. CONCLUSIONS: In this study, Orr-Loygue rectopexy had a lower long-term recurrence rate. However, this surgical procedure is associated with a higher complication rate. We believe that Delorme’s procedure is still a valuable option in selected patients with postoperative minimal morbidity but higher recurrence rate.
治疗完全性直肠脱垂的Delorme手术和Orr-Loygue直肠固定术的长期效果
目的
：本研究目的是评估处置完全性直肠脱垂的Orr-Loygue直肠固定术和Delorme手术（肛门直肠粘膜剔除和直肠肌层折叠术）的长期结果。方法：回顾性收集1978~2001年间的有关资料。统计学分析采用卡方检验和Student’s t 检验。结果：109例患者接受了Orr-Loygue直肠固定术（49例）或Delorme手术（60例）。平均随访时间为88个月（1~300个月）。在直肠固定术组，总的并发症发生率和复发率分别为33%和4%；在术前便秘的患者中，33%术后症状得到改善或完全缓解，58%术后症状加重；在术前大便失禁的患者中，73%术后大便可以控制或大便控制得到改善。在Delorme手术组，总的并发症发生率和复发率分别为15%和23%；术后死亡率为7%；在术前便秘的患者中，54%术后症状得到改善或完全缓解，12.5%术后症状加重；在术前大便失禁的患者中，42%术后大便可以控制或大便控制得到改善。结论：在本研究中，Orr-Loygue直肠固定术的长期术后复发率更低，但该术式的并发症发生率更高（与Delorme手术比较）。我们认为，Delorme手术术后并发症发生率很低，而术后复发率相对较高，挑选合适的直肠脱垂患者选择Delorme手术仍具有价值。
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