Rectoceleに対する経こう門的直腸粘膜焼灼・直腸ちつ壁縫縮法に関する臨床的検討

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  • A Clinical Study on Transanal Repair of Rectocele. Rectal Mucosal Cauterization and Rectovaginal Wall Condensational Suturing Method.

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Rectocele in females is usually caused by weakness in the rectovaginal septum, and that may result in colorectal symptoms such as difficulty in evacuation. In our hospital, rectocele has been operated with transanal technique, because it is of ten accompanied by internal hemorrhoids and/or anal fissure (about 65%) necessitating additional treatment. Furthermore, this method is more acceptable for the patients whose chief complaints are difficulty in defecation. The operating method is as follows : Rectal mucosa of the area of rectocele and its surrounding region is cauterized, but not resected. Stepwise interrupted suture transverse to the submucosal and muscularis layer of the rectum, and levator muscle on both sides of rectocele, is done from the oral side (suturing thread is 2-0 Vicryl) without forming dead space. A drainage wound is created using the technique for resection of an anterior hemorrhoid. Seventy-two rectocele patients were operated in our hospital from Apr. 1997 to Mar. 1999. Symptoms of rectocele have been improved in all symptomatic cases (excellent 39 (65%), good 18 (30%), fair 3 (5 %), poor 0 (0 9/6)) . Healing of the rectocele repair wound was completed within four weeks. No complication has been observed. This transanal technique may be useful in rectocele repair.

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