经阴道纵切横缝术修补直肠前突的临床研究

目的　提高直肠前突所致出口梗性便秘的治疗效果 ,减少直肠前突修补术的术后并发症、后遗症。方法　总结国内外经验 ,在目前经阴道修补直肠前突经典术式基础上改良设计“经阴道纵切横缝术”治疗直肠前突 ,按国内暂行诊治标准[1] 纳入观察组 5 2例 ,历史对照组 5 8例 ,观察组在腰俞穴麻醉下经阴道后壁粘膜皮肤交界处切口入路作长约 3cm的阴道纵切口 ,游离粘膜分离出直肠阴道膈肌肉并作荷包缝合 ,然后将阴道切口最上缘与阴道外口皮肤缝合 ,使纵切口变为横缝合切口 ,术后预防性应用抗菌素 ,局部清洁换药至愈。结果　 5 2例 ,仅 1例无效 ,平均疗程 11± 2 .1天 ,总有效率 98.1% ,无感染及明显后遗症。结论　本疗法具有疗效好、痛苦少、疗程短 ,并发后遗症少等优点

Repair Rectocele with Longitudinal Incision and Transverser Suture on the Vaginal Posterior Wall

Obiective The research aim of repair rectocele is to raise cure rate of constipation of the Outlet-obstruction type caused by rectocele and to reduce the postoperative complication of repairing operation of rectocele. METHODS: 52 cases with rectocele were indentified in our institution over a period from March,1999 to March,2002.The applicant for the treatment of rectocele is a self-design operation by using Longitudinal incision and transverser stuture on the vaginal posterion wall.We longitudinaly incised muscosa on the vaginal about 3cm and divided mucosa and show the vaginal muscle, a purse-sering suture with Catgut was done then transverser suture mucosa and derma. RESULTS: of 52 cases ,only one case (1.9%) have no effect, complete cure was obtained in 37 cases (71%),marked effect in 10(19%),improvement in 4(8%).The total effective rate reached 98.1% and the mean curative period was 11±2.1 days.There was one case (1.9%) have postoperative complication . CONCLUSION: Compared with MS group, the LO group has great advantages of less surgical injury,shortenting treatment course, raising cure rate and reduceing the postoperative complication.