Management of Rectal Prolapse: A Report of Three Cases and Review of the Literature

直腸脫垂的處置：三病例報告及文獻回顧

楊明叡(Ming-Jui Yang)

《中華民國大腸直腸外科醫學會雜誌》 22卷4期 (2011/12) Pp. 146-150

https://doi.org/10.6312/SCRSTW.2011.22(4).10001

摘要

年老便秘病患因長期解便過度用力，可能導致肛門直腸脫垂。直腸脫垂是脫垂的直腸滑出肛門外的疾病，合併有骨盆內部的結構異常。直腸脫垂的症狀包括脫垂出肛門外的直腸組織，和肛門排放黏液出血或大便失禁。多數病人需接受手術治療，修復直腸及減輕大便失禁及排便異常。我們經歷三例直腸脫垂手術的病人。他們接受經會陰或腹部修復手術。我們在此報告並回顧文獻，強調選擇最適當的手術及治療。經腹部乙狀結腸切除及固定直腸骶骨是較常選擇的手術。腹腔鏡手術則提供另一個安全及有效的治療，優點是較小的切口和住院時間縮短。我們認為手術方式的選擇，應取決於病人的狀況和脫垂的程度。

關鍵字

直腸脫垂 ； 直腸固定手術 ； 腹腔鏡手術

並列摘要

In aged and constipated people, long-term straining with defecation may result in anorectal prolapse. Rectal prolapse is the protrusion of the rectum through the anus, and is associated with pelvic anatomical abnormalities. These patients may present with symptoms such as prolapsed anal tissue or a mass, anal mucoid secretions, or bleeding from the protruding tissue. Most patients are advised to have the prolapsed bowel surgically treated in order to correct this disorder, and alleviate any associated constipation or fecal incontinence. We encountered three cases of rectal prolapse that were surgically treated by a transabdominal or transperineal approach.We herein present these cases, and review the related literature emphasizing proper selection of a surgical approach. Laparoscopic techniques are now also available, and can be performed safely and reliably. Nevertheless, the choice of procedure should be individualized to the patient's condition.

並列關鍵字

Rectal prolapse ； Rectopexy ； Laparoscopic operation