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頁籤選單縮合
題名 | Comparison of Abdominal Versus Perineal Resection for Rectal Prolapse=比較經腹部及經會陰部切除直腸脫垂的手術成績 |
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作者姓名(中文) | 陳永誌; 許自齊; 陳明仁; | 書刊名 | 中華民國大腸直腸外科醫學會雜誌 |
卷期 | 27:1 2016.03[民105.03] |
頁次 | 頁45-50 |
分類號 | 416.245 |
關鍵詞 | 腹部切除直腸脫垂手術; 會陰部切除直腸脫垂手術; 直腸脫垂; Abdominal resection; Perineal resection; Rectal prolapse; |
語文 | 英文(English) |
中文摘要 | 目的:外科醫師經腹部及經會陰部切除手術來治療直腸脫垂已經行之有年。經會陰部切除直腸脫垂手術被部分外科醫師所詬病的是其高復發率。本研究在於評估單一外科醫師在經腹部及經會陰部切除直腸脫垂的手術治療上之經驗,並評估經會陰部切除直腸脫垂手術是否為一個好的選擇。方法:自1987年4月至2013年10月,共41位病患接受同一位外科醫師對直腸脫垂進行手術治療。結果:在這些病人中,包含14位男性及27位女性。起初,11位(包含5位男性及6位女性)接受經腹部切除直腸脫垂手術,30位病人(包含9位男性及21位女性)接受經會陰部切除直腸脫垂手術。經腹部切除直腸脫垂手術這一分組平均年紀較輕,平均年齡49.4歲(24到68歲)對比經會陰部切除直腸脫垂手術,平均年齡60.9歲(15到87歲)。經腹部切除直腸脫垂手術這一分組,1位病人術後死亡。2位病人術後出血,1位病人產生復發及1位病人腸道吻合滲漏。經會陰部切除直腸脫垂手術這一分組,沒有病人術後死亡。1位病人產生復發,第二次接受經腹部切除手術;再復發,第三次再接受經會陰部切除直腸脫垂手術。結論:本研究建議經會陰部切除直腸脫垂手術是一個安全且復發率低的手術。經會陰部的方式比經腹部的方式優點有:沒有腹部傷口的併發症,並且較少呼吸方面的問題。 |
英文摘要 | Purpose. Both abdominal and perineal resections have been used by surgeons for management of rectal prolapse. Perineal resection of rectal prolapse has been criticized by, and fallen out of favor with some surgeons for its higher associated rate of recurrence. We compared the result of a surgeon’s experience of abdominal versus perineal resection of rectal prolapse and evaluated whether the latter should be the procedure of choice. Materials and Methods. Charts of 41 patients (April 1987-October 2013) who had rectal prolapsed resected by a senior colorectal surgeon atMackay Memorial Hospital were reviewed. Patient demographics and outcomes were analyzed. Results. Of the 14 male and 27 female patients, eleven (5 male, 6 female) had resection through abdominal approach, and 30 (9 male and 21 female) through perineal approach. Patients age were on average younger for those treated by abdominal approach (24-68 years with an average age of 49.4 years vs 15-87 years average 60.9 years). Complications for patients resected through abdominal approach included: operative mortality (1 patient), postoperative bleeding (2 patients); recurrence of prolapsed (1 patient) and anastomotic leak (1 patient). There was no operative mortality in the patients treated through a perineal approach, and one had a recurrence who was retreated with a second resection through abdominal approach followed by a third resection through a repeat perineal approach. Conclusion. Our results suggested that the perineal resection of rectal prolapse is a safe procedure with low rate of recurrence. Perineal resection also had advantages over abdominal approach of no abdominal wound complications and less compromise of respiratory function. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。