【摘要】 目的 比较STARR术与Bresler术治疗出口梗阻型便秘(ODS)的短期疗效。方法 回顾性分析并比较由直肠前突和/或直肠内脱垂引起的女性出口梗阻型便秘患者行STARR手术或者Bresler手术的临床资料各30例。结果 STARR术平均手术时间14~31 min,平均(23±4)min,术中出血量5~15ml,平均(10±3)ml。术后住院时间4~7 d,平均5 d。术后2例直肠肛门疼痛,其中1例持续至术后6个月;5例轻度大便失禁(肛门失禁评分小于3),均自行恢复;1例吻合口轻度出血。术后均随访6个月,临床疗效评估满意度为76%。Bresler术平均手术时间15~30min,平均(22±5)min,术中出血量5~15 ml,平均(10±2)ml。术后住院时间4~6 d,平均5 d。术后3例直肠肛门疼痛,其中1例持续至术后6个月;4例轻度大便失禁(肛门失禁评分小于3),均自行恢复;2例直肠切割线轻度出血。术后均随访6个月,临床疗效评估满意度为73%。两种手术方式在平均手术时间、术中出血量、术后平均住院时间以及短期临床效果评估上差异均无统计学意义(P>0.05)。结论 对经严格筛选的ODS患者,两种手术方式短期治疗效果相当,但二者长期疗效比较尚需进一步论证。更多还原

【Abstract】 Objective To compare the short-term curative effect between stapled transanal rectal resection(STARR) and Bresler procedures for the treatment of obstructed defecation syndrome(OOC).Methods The clinical data of female patients with OOC caused by rectocele and/or rectal intussusception were retrospectively analyzed,including 30 cases of STARR procedure and 30 cases of Bresler procedure.Results The average operation time of STARR procedure was(23 ±4)min(range 14 ~ 31 min)and the intraoperative blood loss was(10 ±3)ml(range 5~15 ml).The postoperative hospital stay after STARR procedure was 5 days(range 4~7 days).The short-term postoperative complications included 2 cases of anorectal pain,5 cases of minor fecal incontinence(Wexner score < 3) and 1 case of mild anastomotic bleeding.After a six-month follow-up,the postoperative satisfaction rate was 76%.The average operation time of Bresler procedure was(22 ±5)minutes(range 14~30 min)and the intraoperative blood loss was(10 ±2)ml(range 5~15 ml).The postoperative hospital stay after Bresler procedure was 5 days(range4~6 days).The short-term postoperative complications included 3 cases of anorectal pain,5 cases of minor fecal incontinence(Wexner score <3),and 2 cases of mild bleeding from the staple line.After a sixmonth follow-up,the postoperative satisfaction rate was 73%.There were no significant differences in the average operation time,intraoperative blood loss,average postoperative hospitalization time,and short-term clinical effect between two methods(P >0.05).Conclusion STARR and Bresler procedures have similar curative effects on well selected patients with OOC.The differences of long-term efficacy between the two procedures need to be proved by further experiments.更多还原