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经肛吻合器直肠切除术治疗出口梗阻型便秘的并发症分析
引用本文:Zhang B,Ding JH,Zhang M,Yin SH,Feng YY,Zhao Y,Zhu J,Zhao K. 经肛吻合器直肠切除术治疗出口梗阻型便秘的并发症分析[J]. 中华胃肠外科杂志, 2011, 14(12): 934-937. DOI: 10.3760/cma.j.issn.1671-0274.2011.12.006
作者姓名:Zhang B  Ding JH  Zhang M  Yin SH  Feng YY  Zhao Y  Zhu J  Zhao K
作者单位:1. 第二炮兵总医院肛肠外科全军肛肠病专病中心,北京,100088
2. 第二炮兵总医院实验室,北京,100088
基金项目:北京市科委课题"首都临床特色应用研究"
摘    要:目的评价经肛吻合器直肠切除术(STARR)治疗出口梗阻型便秘(ODS)的安全性。方法回顾性分析2007年1月至2008年10月间第二炮兵总医院采用STARR治疗112例直肠前突和(或)直肠内套叠相关性ODS女性病例的临床资料.统计围手术期及术后远期并发症发生情况。结果术后早期发生并发症18例(16.1%),包括肛门失禁(4.5%)、吻合口出血(2.7%)、吻合口部分裂开(0.9%)、肛裂(2.7%)、急性尿潴留(1.8%)、血栓性外痔(1.8%)、直肠阴道隔血肿(0.9%)、粪便嵌塞(0.9%),其中2例患者(1.8%)因并发症需再次手术干预。术后中位随访24个月,远期发生并发症6例(5.4%),包括:肛门失禁(1.8%)、排粪急迫感(0.9%)、吻合口周围炎致慢性疼痛(1.8%)、直肠憩室致慢性疼痛(0.9%),其中3例患者(2.7%)需手术治疗。结论STARR是治疗出口梗阻型便秘相对安全的术式。

关 键 词:经肛吻合器直肠切除术  出口梗阻型便秘  直肠前突  直肠内套叠

Complications after stapled transanal rectal resection for obstructed defecation
Zhang Bin,Ding Jian-hua,Zhang Meng,Yin Shu-hui,Feng Ying-ying,Zhao Yong,Zhu Jun,Zhao Ke. Complications after stapled transanal rectal resection for obstructed defecation[J]. Chinese journal of gastrointestinal surgery, 2011, 14(12): 934-937. DOI: 10.3760/cma.j.issn.1671-0274.2011.12.006
Authors:Zhang Bin  Ding Jian-hua  Zhang Meng  Yin Shu-hui  Feng Ying-ying  Zhao Yong  Zhu Jun  Zhao Ke
Affiliation:Department of Colorectal Disease Surgery, The Second Artillary General Hospital, Beijing 100088, China.
Abstract:Objective To evaluate the safety of stapled transanal rectal resection(STARR)for the treatment of obstructed defecation syndrome (ODS).Methods A retrospective study was performed in 112 female patients with ODS eligible for STARR.The short-lerm and long-term postoperative complications were recorded and assessed.Results Short-term postoperative complications and adverse events were reported in 18 patients(16.1%) including fecal incontinence(4.5%),anastomotic bleeding (2.7%),staple line partial dehiscence (0.9%),anal fissure (2.7%),acute urinary retention( 1.8% ),thrombosed external hemorrhoid( 1.8% ),hematoma of the rectovaginal septum (0.9%)and fecal impaction (0.9%).Reoperation was required in 2 patients (1.8%) due to the short-term postoperative complications.The median length of follow-up was 24 months.There were 6 patients with long-term postoperative complications (5.4%) including fecal incontinence (1.8%),defecatory urgency (0.9%),chronic pain due to anastomotic inflammation (1.8%),and chronic pain due to anal rectal diverticulum(0.9%).Three patients(2.7%) were reoperated.Conclusion STARR appears to be a safe technique for patients with obstructed defecation.
Keywords:Stapled transanal rectal resection  Obstructed defecation syndrome  Rectocele  Rectal intussusception
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