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| Clinical effect of transanal contour-curved stapler in the treatment of rectocele |
| ZHAO Liang1 WANG Zhigang1 YUAN Hexue2 |
1.Five Treatment Area, Colorectal and Anal Wards, Shenyang Anorectal Hospital, Liaoning Province, Shenyang 110000, China;
2.Three Treatment Area, Colorectal and Anal Wards, Shenyang Anorectal Hospital, Liaoning Province, Shenyang 110000, China |
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Abstract Objective To study clinical effect of partial resection of rectum anterior wall of transanal contour-curved stapler (CCS) in the treatment of rectocele. Methods From January 2018 to January 2020, 40 adult females with rectocele in Shenyang Anorectal Hospital received partial resection of rectum anterior wall of transanal CCS were selected as research objects. The status of postoperative outlet obstruction and the effect of operation were evaluated through obstruction defecation syndrome (ODS) score, efficacy evaluation, imaging improvement and satisfaction of patient survey. Results Forty cases were operated successfully, the operation time was 25 to 40 minutes, the average operation time was (32±4) minutes. The blood loss was 10 to 30 milliliters, and the average blood loss was (20±5) milliliters. The signs of rectocele decreased significantly after operation. There were no complications such as massive hemorrhage, rectovaginal fistula, rectal stricture, anal stricture, perianal abscess and perioperative death. The postoperative ODS score was significantly lower than that before operation (P < 0.05). The depth of rectocele after operation was significantly shorter than that before operation (P < 0.05). Curative effect evaluation: five cases were cured, 15 cases were markedly effective, 20 cases were effective, no one was invalid, the total effective rate was 100%. Postoperative patient satisfaction survey: 24 cases were satisfied, 16 cases were basically satisfied, and no one was dissatisfied. Conclusion Partial resection of rectum anterior wall of transanal CCS is an effective method for the treatment of ODS with rectocele, which is characterized as safe, simple, short operation time and less postoperative complications etc.
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[1] 赵志勇.经肛吻合器直肠黏膜环形切除术治疗直肠前突临床效果观察[J].当代医学，2017，23（11）：83-84.
[2] Schwandner O. Obstructed defecation syndrome：aetiology，diagnostic assessment and therapeutic options [J]. Zentralbl Chir，2019，144（4）：387-395.
[3] Renzi A，Talento P，Giardiello C，et al. Stapled transanal rectal resection （STARR） by a new dedicated device for the surgical treatment of obstructed defaecation syndrome caused by rectal intussusception and rectocele：early results of a multicenter prospective study [J]. Int J Colorectal Dis，2008，23（10）：999-1005.
[4] Mallick S，Benson R，Haresh KP，et al. Neoadjuvant treatment intensification or adjuvant chemotherapy for locally advanced carcinoma rectum：the optimum treatment approach remains unresolved [J]. J Egypt Natl Canc Inst，2015，27（4）：179-185.
[5] 张正国，杨光，杨勇，等.TST STARR术治疗出口梗阻型便秘的临床研究[J].中华胃肠外科杂志，2016，19（1）：88-90.
[6] 吴硕儒，夏静，徐言，等.罗马Ⅳ诊断标准对肠易激综合征患者的影响程度[J].中华消化杂志，2019，39（3）：167-172.
[7] Altomare DF，Picciariello A，Memeo R，et al. Pelvic floor function following ventral rectopexy versus STARR in the treatment of obstructed defecation [J]. Tech Coloproctol，2018，22（4）：289-294.
[8] 王威.选择性痔上黏膜切除吻合术治疗直肠前突的临床疗效观察[D].成都：成都中医药大学，2013：1-50.
[9] 商善良，杨关根，廖秀军，等.经肛门腔镜直线切割缝合器治疗直肠前突的临床疗效分析[J].中国内镜杂志，2015， 21（5）：449-453.
[10] 徐昭娟，薛伟彩，白建英，等.直肠前突型便秘的中西医结合治疗进展及思考[J].中国中西医结合消化杂志，2017， 25（8）：638-640.
[11] Sákra L，?譒iller J. Obstructed defecation syndrome-review article [J]. Rozhl Chir，2017，96（6）：247-251.
[12] 吴瑜梅.经肛吻合器直肠黏膜切除术与经直肠闭式修补术治疗直肠前突的疗效比较[J].医学信息，2017，30（17）：69-70.
[13] 张忠伟，刘扬，路明.痔上黏膜环切术治疗直肠前突所致出口梗阻型便秘的疗效观察[J].临床外科杂志，2016， 24（10）：774-776.
[14] 刘智勇，杨关根，邓群，等.部分吻合器经肛门直肠切除术联合Bresler术治疗直肠前突合并直肠内套叠疗效观察[J].中华胃肠外科杂志，2016，19（5）：566-570.
[15] Naldini G，Fabiani B，Menconi C，et al. Treatment of obstructed defecation syndrome due to rectocele and rectal intussusception with a high volume stapler （TST STARR-plus） [J]. Tech Coloproctol，2018，22（1）：53-58.
[16] Renzi A，Brillantino A，Di Sarno G，et al. Improved clinical outcomes with a new contour-curved stapler in the surgical treatment of obstructed defecation syndrome：a midterm randomized controlled trial [J]. Dis Colon Rectum，2011，54（6）：736-742.
[17] Boccasanta P，Venturi M，Roviaro G. What is the benefit of anew stapler device in the surgical treatment of obstructed defecation? Three-year outcomes from a randomized controlled trial [J]. Dis Colon Rectum，2011，54（1）：77-84.
[18] Shafik AA，El Sibai O，Shafik IA. Rectocele repair with stapled transvaginal rectal resection [J]. Tech Coloproctol，2016，20（4）：207-214.
[19] 陈敏.经肛腔镜直线切割吻合器直肠前突修补术的临床应用[J].影像研究与医学应用，2017，1（5）：218-219.
[20] Liu WC，Wan SL，Yaseen SM，et al. Transanal surgery for obstructed defecation syndrome：literature review and a single-center experience [J]. World J Gastroenterol，2016，22（35）：7983-7998.
[21] Shao Y，Fu YX，Wang QF，et al. Khubchandani’s procedure combined with stapled posterior rectal wall resection for rectocele [J]. World J Gastroenterol，2019，25（11）：1421-1431.
[22] Guttadauro A，Chiarelli M，Maternini M，et al. Value and limits of stapled transanal rectal repair for obstructed defecation syndrome：10 years-experience with 450 cases [J]. Asian J Surg，2018，41（6）：573-577.
[23] Picciariello A，Papagni V，Martines G，et al. Post-operative clinical，manometric，and defecographic findings in patients undergoing unsuccessful STARR operation for obstructed defecation [J]. Int J Colorectal Dis，2019，34（5）：837-842.
[24] Renzi A，Brillantino A，Di Sarno G，et al. Evaluating the surgeons’ perception of difficulties of two techniques to perform starr for obstructed defecation syndrome：a multicenter randomized trial [J]. Surg Innov，2016，23（6）：563-571.
[25] Boccasanta P，Agradi S，Vergani C，et al. The evolution of transanal surgery for obstructed defecation syndrome：midterm results from a randomized study comparing double TST 36 HV and Contour TRANSTAR staplers [J]. Am J Surg，2018，216（5）：893-899.
[26] Regadas FSP，Murad-Regadas SM，Rodrigues LV，et al. Impact of TRREMS on symptoms of obstructed defecation due to rectocele：predictive factors and outcomes [J]. Tech Coloproctol，2020，24（1）：65-73. |
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