Stapled Trans-anal Rectal Resection and Altemeir's Resection for Rectum Prolapse in Spinal Cord Injury Patients
10.3969/j.issn.1006-9771.2012.03.027
- VernacularTitle:脊髓损伤患者直肠脱垂的手术治疗
- Author:
Fei GAO
;
Fengliang ZHANG
;
Lianyuan TAO
;
Jianjun LI
;
Qing XU
- Publication Type:Journal Article
- Keywords:
spinal cord injury, rectal prolapse, stapled trans-anal rectal resection, Altemeir's resection
- From:
Chinese Journal of Rehabilitation Theory and Practice
2012;18(3):282-285
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the stapled trans-anal rectal resection (STARR) and Altemeir's resection for rectum prolapse in spinalcord injury (SCI) patients. Methods Anus bowel disease of 260 SCI patients were investigated, 21 cases with rectum prolapse who wereinvalid for nonoperative treatment chose Altemeir's resection or STARR depending on the degree of rectum prolapse. They were recorded ac- cording to International Spinal Cord Injury Bowel Function Based and Extension Set before and 12 months after operation. Results 85 SCIpatients were with rectum prolapse (32.7%), 21 patients complicated with constipation and mixed hemorrhoid, 19 with rectal mucous membraneprolapse (<7 cm), 4 with rectal internal mucous intussusception, 2 were completely rectum prolapse (≥7 cm). Rectum prolapse of Ⅰdegree was found in 13 cases, Ⅱ in 5 cases, and Ⅲ in 3 cases. Patients with Ⅰ or Ⅱ degrees rectum prolapse accepted STARR, those withⅢ degrees accepted Altemeir's resection. No serious complication was found. Self-report of intestinal dysfunction affecting the quality oflife during the 12 months after operation significantly decreased (P<0.01), so as the need of drawing out defecate with hands (P<0.01), theusage of liner, plug, or antidiarrheal (P<0.001). The symptom such as endless defecate feeling, abdominal distension, abdominal pain, abdominaldiscomfort were significantly alleviated (P<0.05). Conclusion STARR and Altemeir's resection are both safe and effective operationfor rectum prolapse in SCI patients.