Comparison of the medium- and long-term clinical effects of procedure for prolapse and hemorrhoids combined with Block operation in treatment of obstructed defecation syndrome_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LI Xiaojun ¹ , FAN Leitao ² ,  LI Chunyu ³

1. The Third Department of General Surgery, Chaoyang City Central Hospital, Chaoyang, Liaoning 122000, P. R. China;
2. Anorectal Department, Chaoyang City Central Hospital, Chaoyang, Liaoning 122000, P. R. China;
3. Department of Anus and Intestine Surgery, The Fourth Affiliated Hospital of China Medical University, Shengyang 110032, P. R. China;

Corresponding?author：

LI Chunyu, Email: lcy133000@163.com

Keywords：

obstructed defecation syndrome; procedure for prolapse and hemorrhoids; Block operation; rectocele; clinical effect

DOI：

10.7507/1007-9424.201708027

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To explore the medium- and long-term clinical effects of procedure for prolapse and hemorrhoids (PPH) combined with Block operation for obstructed defecation syndrome (ODS). Methods Clinical data of 187 patients with ODS caused by rectocele (RE) who received PPH+Block operation or pure PPH operation in The Chaoyang City Central Hospital from Mar. 2011 to May. 2013, were collected retrospectively, in which 95 patients underwent PPH+Block operation (PPH+Block group) and 92 patients underwent PPH operation (PPH group). Compared the postoperative Longo’s score, postoperative clinical effect, operative effect, and recurrence rate between the 2 groups. Results ① The postoperative Longo’s score: the postoperative Longo’s scores of the PPH+Block group were both lower than those of the PPH group at 1- and 3-year after operation (P<0.05). ② Postoperative curative effect: the total effective rate of the PPH+Block group and the PPH group were both 100%, but the clinical effect of the the PPH+Block group was better than that of the PPH group (Z=–10.15, P<0.05). ③ Operative effect: there was no statistical significance on operative time, intraoperative blood loss, returned to normal activity time, hospital stay, and postoperative visual analogy score (VAS) between the 2 groups (P>0.05). In addition, there were no statistical significance on the incidences of urinary retention, hematochezia, exhaust anal incontinence, and anal fissure between the 2 groups (P>0.05), but the incidence of urgent or high anal straining feeling in the PPH+Block group was significantly higher than that of the PPH group (P<0.05). ④ Medium- and long-term recurrence rate: the recurrence rate of 1-year after operation was similar between these2 groups (P>0.05), but the recurrence rate of 3-year after operation in the PPH+Block group was significantly lower than that of the PPH group (P<0.05). Conclusions The medium clinical effect has no obvious difference between PPH+Block and PPH operation, but the long-term recurrence rate of the former is lower than that of the latter, and the medium- and long-term effect is stable in PPH+Block operation for ODS caused by RE.

Citation： LI Xiaojun, FAN Leitao, LI Chunyu. Comparison of the medium- and long-term clinical effects of procedure for prolapse and hemorrhoids combined with Block operation in treatment of obstructed defecation syndrome. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2018, 25(2): 202-206. doi: 10.7507/1007-9424.201708027 Copy

1.	Higgins PD, Johanson JF. Epidemiology of constipation in North America: a systematic review. Am J Gastroenterol, 2004, 99(4): 750-759.
2.	Schwandner O, Stuto A, Jayne D, et al. Decision-making algorithm for the STARR procedure in obstructed defecation syndrome: position statement of the group of STARR pioneers. Surg Innov, 2008, 15(2): 105-109.
3.	Boccasanta P, Venturi M, Roviaro G. What is the benefit of a new stapler device in the surgical treatment of obstructed defecation? Three-year outcomes from a randomized controlled trial. Dis Colon Rectum, 2011, 54(1): 77-84.
4.	Madbouly KM, Abbas KS, Hussein AM. Disappointing long-term outcomes after stapled transanal rectal resection for obstructed defecation. World J Surg, 2010, 34(9): 2191-2196.
5.	袁鹿, 郭劍波, 林樹森, 等. 經肛吻合器直腸黏膜切除術與經直腸閉式修補術治療直腸前突的對比研究. 中國普外基礎與臨床雜志, 2012, 19(2): 151-156.
6.	Drossman DA. The functional gastrointestinal disorders and the Rome III process. Gastroenterology, 2006, 130(5): 1377-1390.
7.	李春雨. 肛腸病學. 北京: 高等教育出版社, 2013: 93, 189-190.
8.	李春雨, 張有生. 實用肛門手術學. 沈陽: 遼寧科技出版社, 2005: 229-230.
9.	袁鵬, 范雷濤, 李春雨. 吻合器痔上黏膜環形切除釘合術治療 104 例直腸前突所致便秘的療效. 中國普外基礎與臨床雜志, 2013, 20(8): 940-942.
10.	Tong DM, Zhou YT, Wang GS, et al. Early prediction and outcome of septic encephalopathy in acute stroke patients with nosocomial coma. J Clin Med Res, 2015, 7(7): 534-539.
11.	Choi JS, Hwang YH, Salum MR, et al. Outcome and management of patients with large rectoanal intussusception. Am J Gastroenterol, 2001, 96(3): 740-744.
12.	Petersen S, Hellmich G, Schuster A, et al. Stapled transanal rectal resection under laparoscopic surveillance for rectocele and concomitant enterocele. Dis Colon Rectum, 2006, 49(5): 685-689.
13.	周亮, 洪流東, 陳富. 經肛門鏡下吻合器治療直腸前突的療效及生活質量變. 中國國中西醫結合外科雜志, 2015, 21(1): 59-61.
14.	張斌, 丁健華, 張萌, 等. 經肛吻合器直腸切除術治療出口梗阻型便秘的并發癥分析. 中華胃腸外科雜志, 2011, 14(12): 934-937.
15.	譚書錦, 別君. PPH 治療直腸前突所致出口梗阻性便秘的近遠期療效評估. 中國醫藥導刊, 2014, 2(16): 193-194, 196.
16.	張正國, 楊光, 楊勇, 等. TST STARR+術治療出口梗阻型便秘的臨床研究. 中華胃腸外科雜志, 2016, 19(1): 88-90.
17.	Sciaudone G, Di Stazio C, Guadagni I, et al. Rectal diverticulum: a new complication of STARR procedure for obstructed defecation. Tech Coloproctol, 2008, 12(1): 61-63.
18.	Zhang ZG, Yang G, Pan D, et al. Efficacy of endoscopic stapled transanal rectal resection for the treatment of rectocele. Eur Rev Med Pharmacol Sci, 2014, 18(24): 3921-3926.
19.	李鳳霞, 張立濤, 陳志仁. 老年女性直腸前突合并直腸內脫垂 118 例的治療體會. 中國老年學雜志, 2007, 27(9): 898-899.
20.	韓飛, 段曉, 李鵬, 等. 直腸脫垂 56 例診治體會. 中國醫師進修雜志, 2013, 36(6): 63-64.
21.	袁鵬, 李春雨, 王墨飛. 吻合器痔上黏膜環形切除釘合術治療老年女性直腸前突 63 例. 中國普外基礎與臨床雜志, 2011, 18(12): 1317-1318.
22.	Pescatori M, Zbar AP. Reinterventions after complicated or failed STARR procedure. Int J Colorectal Dis, 2009, 24(1): 87-95.
23.	Dodi G, Pietroletti R, Milito G, et al. Bleeding, incontinence, pain and constipation after STARR transanal double stapling rectotomy for obstructed defecation. Tech Coloproctol, 2003, 7(3): 148-153.
24.	胡晟云, 王時俊, 徐紀中, 等. PPH 聯合直腸黏膜柱狀縫扎術治療出口梗阻性便秘的臨床效果分析. 河南醫學研究, 2017, 26(6): 997-999.
25.	項雄華, 卿艷平, 吳為明, 等. 痔上黏膜環切術聯合經直腸直腸前突閉式修補術治療直腸前突臨床療效觀察. 中國醫師進修雜志, 2014, 37(32): 44-46.

1. Higgins PD, Johanson JF. Epidemiology of constipation in North America: a systematic review. Am J Gastroenterol, 2004, 99(4): 750-759.
2. Schwandner O, Stuto A, Jayne D, et al. Decision-making algorithm for the STARR procedure in obstructed defecation syndrome: position statement of the group of STARR pioneers. Surg Innov, 2008, 15(2): 105-109.
3. Boccasanta P, Venturi M, Roviaro G. What is the benefit of a new stapler device in the surgical treatment of obstructed defecation? Three-year outcomes from a randomized controlled trial. Dis Colon Rectum, 2011, 54(1): 77-84.
4. Madbouly KM, Abbas KS, Hussein AM. Disappointing long-term outcomes after stapled transanal rectal resection for obstructed defecation. World J Surg, 2010, 34(9): 2191-2196.
5. 袁鹿, 郭劍波, 林樹森, 等. 經肛吻合器直腸黏膜切除術與經直腸閉式修補術治療直腸前突的對比研究. 中國普外基礎與臨床雜志, 2012, 19(2): 151-156.
6. Drossman DA. The functional gastrointestinal disorders and the Rome III process. Gastroenterology, 2006, 130(5): 1377-1390.
7. 李春雨. 肛腸病學. 北京: 高等教育出版社, 2013: 93, 189-190.
8. 李春雨, 張有生. 實用肛門手術學. 沈陽: 遼寧科技出版社, 2005: 229-230.
9. 袁鵬, 范雷濤, 李春雨. 吻合器痔上黏膜環形切除釘合術治療 104 例直腸前突所致便秘的療效. 中國普外基礎與臨床雜志, 2013, 20(8): 940-942.
10. Tong DM, Zhou YT, Wang GS, et al. Early prediction and outcome of septic encephalopathy in acute stroke patients with nosocomial coma. J Clin Med Res, 2015, 7(7): 534-539.
11. Choi JS, Hwang YH, Salum MR, et al. Outcome and management of patients with large rectoanal intussusception. Am J Gastroenterol, 2001, 96(3): 740-744.
12. Petersen S, Hellmich G, Schuster A, et al. Stapled transanal rectal resection under laparoscopic surveillance for rectocele and concomitant enterocele. Dis Colon Rectum, 2006, 49(5): 685-689.
13. 周亮, 洪流東, 陳富. 經肛門鏡下吻合器治療直腸前突的療效及生活質量變. 中國國中西醫結合外科雜志, 2015, 21(1): 59-61.
14. 張斌, 丁健華, 張萌, 等. 經肛吻合器直腸切除術治療出口梗阻型便秘的并發癥分析. 中華胃腸外科雜志, 2011, 14(12): 934-937.
15. 譚書錦, 別君. PPH 治療直腸前突所致出口梗阻性便秘的近遠期療效評估. 中國醫藥導刊, 2014, 2(16): 193-194, 196.
16. 張正國, 楊光, 楊勇, 等. TST STARR+術治療出口梗阻型便秘的臨床研究. 中華胃腸外科雜志, 2016, 19(1): 88-90.
17. Sciaudone G, Di Stazio C, Guadagni I, et al. Rectal diverticulum: a new complication of STARR procedure for obstructed defecation. Tech Coloproctol, 2008, 12(1): 61-63.
18. Zhang ZG, Yang G, Pan D, et al. Efficacy of endoscopic stapled transanal rectal resection for the treatment of rectocele. Eur Rev Med Pharmacol Sci, 2014, 18(24): 3921-3926.
19. 李鳳霞, 張立濤, 陳志仁. 老年女性直腸前突合并直腸內脫垂 118 例的治療體會. 中國老年學雜志, 2007, 27(9): 898-899.
20. 韓飛, 段曉, 李鵬, 等. 直腸脫垂 56 例診治體會. 中國醫師進修雜志, 2013, 36(6): 63-64.
21. 袁鵬, 李春雨, 王墨飛. 吻合器痔上黏膜環形切除釘合術治療老年女性直腸前突 63 例. 中國普外基礎與臨床雜志, 2011, 18(12): 1317-1318.
22. Pescatori M, Zbar AP. Reinterventions after complicated or failed STARR procedure. Int J Colorectal Dis, 2009, 24(1): 87-95.
23. Dodi G, Pietroletti R, Milito G, et al. Bleeding, incontinence, pain and constipation after STARR transanal double stapling rectotomy for obstructed defecation. Tech Coloproctol, 2003, 7(3): 148-153.
24. 胡晟云, 王時俊, 徐紀中, 等. PPH 聯合直腸黏膜柱狀縫扎術治療出口梗阻性便秘的臨床效果分析. 河南醫學研究, 2017, 26(6): 997-999.
25. 項雄華, 卿艷平, 吳為明, 等. 痔上黏膜環切術聯合經直腸直腸前突閉式修補術治療直腸前突臨床療效觀察. 中國醫師進修雜志, 2014, 37(32): 44-46.

Previous Article
Clinical application of early enteral nutrition following radical resection for patients with gastric cancer
Next Article
Caudate lobe-sparing subtotal hepatectomy in treatment of hepatolithiasis

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Comparison of the medium- and long-term clinical effects of procedure for prolapse and hemorrhoids combined with Block operation in treatment of obstructed defecation syndrome

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content