CAJ | 학술논문

目的评价Altemeier手术在嵌顿性直肠脱垂急诊处理中的应用价值.方法回顾性分析经Altemeier手术急诊治疗的9例嵌顿性直肠脱垂患者的临床资料.结果本组9例患者均行经会阴直肠乙状结肠部分切除术,手术时间1.0～1.5(平均1.7)h,术中失血50～200(平均109)ml,术后首次排便时间1～6(平均2.8)d,总住院时间3～10(平均5.3)d.术后无吻合口瘘、腹腔感染、泌尿生殖功能障碍等并发症发生,1例患者术后直肠系膜血栓形成,1例患者出现肛门不适症状.术后经5个月至6.5年(平均3.5年)的随访,所有患者未出现再次脱垂.术后6个月肛门功能Kirwan Ⅰ级8例,Ⅱ级1例;所有患者均感到满意.结论 Altemeier手术治疗嵌顿性直肠脱垂术后肛门功能良好,可作为嵌顿性直肠脱垂急诊处理的首选术式之一.
목적 평개Altemeier수술재감돈성직장탈수급진처리중적응용개치.방법 회고성분석경Altemeier수술급진치료적9례감돈성직장탈수환자적림상자료.결과본조9례환자균행경회음직장을상결장부분절제술,수술시간1.0～1.5(평균1.7)h,술중실혈50～200(평균109)ml,술후수차배편시간1～6(평균2.8)d,총주원시간3～10(평균5.3)d.술후무문합구루、복강감염、비뇨생식공능장애등병발증발생,1례환자술후직장계막혈전형성,1례환자출현항문불괄증상.술후경5개월지6.5년(평균3.5년)적수방,소유환자미출현재차탈수.술후6개월항문공능Kirwan Ⅰ급8례,Ⅱ급1례;소유환자균감도만의.결론 Altemeier수술치료감돈성직장탈수술후항문공능량호,가작위감돈성직장탈수급진처리적수선술식지일.
Objective To evaluate the perineal rectosigmoidectomy(Altemeier procedure) in the emergent management of acute incarcerated rectal prolapse. Methods Clinical and follow-up data of 9 patients with acute incarcerated rectal prolapse undergone Altemeier procedure were retrospectively analyzed. Results The mean operation time was 1.7 (range 1.0-1.5) hours. The mean total blood loss during surgery was 109 (50-200) ml. The mean time to the first bowel movements was 2.8(1-6) days after surgery. The hospital stay was 5.3 (3-10) days. There were no postoperative complications such as anastomotic leakage, intra-abdominal infection, or urogenital dysfunction. One patient developed thrombosis in the mesorectum and one patient had symptoms of anal discomfort. After a mean follow-up of 3.5 (5 months-6.5 years) years, no patient had recurrent prolapse. Six months after operation, anal function was Kirwan grade Ⅰ in 8 cases and grade Ⅱ in 1 case. All the patients were satisfied with the result. Conclusion Altemeier procedure can result in good postoperative anal function when treating incarcerated rectal prolapse, which shonld be the first choice in emergency treatment.