A postoperative complication after Altemeier operation, so far never reported,is described in a 42 years old mentally disabled patient with external full thickness rectal prolapse who usually had prolonged straining a...A postoperative complication after Altemeier operation, so far never reported,is described in a 42 years old mentally disabled patient with external full thickness rectal prolapse who usually had prolonged straining at defecation.After 6 d from perineal rectosigmoidectomy, the patient,was discharged free of complications.Four days later he was readmitted in emergency for stran-gulated perineal trans-anastomotic ileal hernia that occurred at home during efforts to defecate.The clinical feature required an emergency operation for repositioning the ileal loops into the abdomen,resection of the necrotic ileum,and end colostomy.The outcome of the second operation was free of complication and the patient was discharged on the 6th postoperative day.In conclusion,after Altemeier operation prolonged straining at defecation should be carefully展开更多
目的观察盆底重建联合吻合器痔上黏膜环切术(procedure for prolapse and hemorrhoids,PPH)治疗Ⅱ、Ⅲ度直肠脱垂的效果以及对患者炎性及应激反应的影响。方法选取Ⅱ、Ⅲ度直肠脱垂患者208例,随机分为观察组和对照组各104例,观察组行盆...目的观察盆底重建联合吻合器痔上黏膜环切术(procedure for prolapse and hemorrhoids,PPH)治疗Ⅱ、Ⅲ度直肠脱垂的效果以及对患者炎性及应激反应的影响。方法选取Ⅱ、Ⅲ度直肠脱垂患者208例,随机分为观察组和对照组各104例,观察组行盆底重建联合PPH治疗,对照组行直肠悬吊联合肛门紧缩术治疗,比较2组治疗效果、术后炎症细胞因子水平及应激反应指标。结果观察组一次修补成功率明显高于对照组,术后并发症发生率明显低于对照组,差异均有统计学意义(P<0.05)。治疗后2组皮质醇(cortisol,COR)、去甲肾上腺素(norepinephrine,NE)、前列腺素E2(prostaglandin E2,PGE2)、白细胞介素6(interleukin-6,IL-6)、白细胞介素10(interleukin-10,IL-10)及C反应蛋白(C-reactive protein,CRP)水平较治疗前明显升高,差异均有统计学意义(P<0.05);2组间COR、NE、PGE2、IL-6、IL-10及CRP水平差异均无统计学意义(P>0.05)。结论重建盆底联合PPH可有效治疗Ⅱ、Ⅲ度直肠脱垂患者,并能降低患者术后并发症发生率及复发率,且对术后患者炎症及应激反应无明显影响,在Ⅱ、Ⅲ度直肠脱垂治疗中较直肠悬吊联合肛门缩紧术优势明显。展开更多
文摘A postoperative complication after Altemeier operation, so far never reported,is described in a 42 years old mentally disabled patient with external full thickness rectal prolapse who usually had prolonged straining at defecation.After 6 d from perineal rectosigmoidectomy, the patient,was discharged free of complications.Four days later he was readmitted in emergency for stran-gulated perineal trans-anastomotic ileal hernia that occurred at home during efforts to defecate.The clinical feature required an emergency operation for repositioning the ileal loops into the abdomen,resection of the necrotic ileum,and end colostomy.The outcome of the second operation was free of complication and the patient was discharged on the 6th postoperative day.In conclusion,after Altemeier operation prolonged straining at defecation should be carefully
文摘目的观察盆底重建联合吻合器痔上黏膜环切术(procedure for prolapse and hemorrhoids,PPH)治疗Ⅱ、Ⅲ度直肠脱垂的效果以及对患者炎性及应激反应的影响。方法选取Ⅱ、Ⅲ度直肠脱垂患者208例,随机分为观察组和对照组各104例,观察组行盆底重建联合PPH治疗,对照组行直肠悬吊联合肛门紧缩术治疗,比较2组治疗效果、术后炎症细胞因子水平及应激反应指标。结果观察组一次修补成功率明显高于对照组,术后并发症发生率明显低于对照组,差异均有统计学意义(P<0.05)。治疗后2组皮质醇(cortisol,COR)、去甲肾上腺素(norepinephrine,NE)、前列腺素E2(prostaglandin E2,PGE2)、白细胞介素6(interleukin-6,IL-6)、白细胞介素10(interleukin-10,IL-10)及C反应蛋白(C-reactive protein,CRP)水平较治疗前明显升高,差异均有统计学意义(P<0.05);2组间COR、NE、PGE2、IL-6、IL-10及CRP水平差异均无统计学意义(P>0.05)。结论重建盆底联合PPH可有效治疗Ⅱ、Ⅲ度直肠脱垂患者,并能降低患者术后并发症发生率及复发率,且对术后患者炎症及应激反应无明显影响,在Ⅱ、Ⅲ度直肠脱垂治疗中较直肠悬吊联合肛门缩紧术优势明显。
