圆形吻合器直肠黏膜环切术治疗直肠黏膜脱垂的疗效

目的评价采用圆形吻合器治疗直肠黏膜脱垂的安全性和可行性.方法回顾性分析2002年10月至2004年1月手术治疗的18例直肠黏膜脱垂病人,均经排粪造影诊断.结果 18例中直肠黏膜内脱垂8例;直肠黏膜外脱垂合并痔脱出10例.手术时间0.3～1.0 h (平均0.53 h),吻合口距齿状线的距离1.0～2.5 cm(平均1.9 cm).黏膜切除上下平均宽度为2.5～3.5 cm.环切黏膜圈完整15例;不完整3例.术后随访1月～12月,均对手术效果满意,直肠黏膜脱垂无复发,1例6月后仍便血.结论圆形痔吻合器经肛门直肠黏膜环切术是治疗直肠黏膜脱垂的有效方法,手术简便.

Treatment of 18 patients with rectal mucosal prolapse using rectal mucosal sleeve resection by the circular stapler

Objective To evaluate the safety and efficacy for rectal mucosal prolapse using a hemorrhoidal circular stapler device. Methods A total of 18 patients with rectal mucosal prolapse treated surgically from October 2002 to January 2004 were analyzed retrospectively. All the patients were diagnosed by defecography. Results Internal rectal mucosal prolapse was found in 8 patients and external rectal mucosal prolapse with prolapsed hemorrhoids in 10 patients out of the 18 patients. The operation time ranged from 0.3 to 1.0 h (averaging 0.53 h). The distance of the anastomosis from the dentate line ranged from 1.0 to 2.5 cm (averaging 1.9 cm). The average width of the resected mucous membrane ranged from 2.5 to 3.5 cm. Complete rectal mucosal sleeve resection was performed in 15 cases, but incomplete in 3 cases. The follow up (1-12 months) showed satisfactory surgical outcomes and no recurrence of prolapse in all cases. Rectal bleeding occurred in 1 case 6 months after operation. Conclusion The transanal rectal mucosal sleeve resection by a stapler device is a safe, easy, and effective surgical method for rectal mucosal prolapse.