Use Of Two Kinds Of Improved Stapled Transanal Rectal Resection In The Treatment Of Rectocele

Objective : To compare and analyze three surgical methods for the treatment of rectocele,to provide evidence for the clinical feasibility of improved STARR.Methods:From May 2013 to November 2015,92 patients with rectocele were treated in the First Affiliated Hospital of Bengbu Medical College.According to the inclusion criteria and exclusion criteria,a total of 90 patients who met the criteria were included in the study.Ninety patients were all female,according to the time of admission,they were randomly divided into three groups:group I,group II,and group III.There were30 patients in groupⅠ,aged 38 to 65 years old,the average age was(54.47±6.89)years;the courses were 1 to 12 years,the average course was(6.75±2.85)years;defecography showed that the depth of rectocele of 12 cases was 1.6 ~ 3.0cm,the depth of other 18 cases was≥3.1cm,The average depth was(4.18±1.35)cm.There were30 patients in groupⅡ,aged 41 to 65 years old,the average age was(54.23±6.84)years;the courses were 0.5 to 11 years,the average course was(6.57±2.96)years;defecography showed that the depth of rectocele of 14 cases was 1.6 ~ 3.0cm,the depth of other 16 cases was≥3.1cm,The average depth was(4.03±1.36)cm.There were30 patients in groupⅢ,aged 42 to 68 years old,the average age was(54.33±6.98)years;the courses were 1 to 13 years,the average course was(6.60±2.91)years;defecography showed that the depth of rectocele of 11 cases was 1.6 ~ 3.0cm,the depth of other 19 cases was≥3.1cm,The average depth was(4.27±1.30)cm.There was no significant difference between the three groups in the age,course of disease and the depth of rectocele,the difference was not statistically significant(all P>0.05),They are comparable.Improved STARR 1 was used for the treatment of rectocele in groupⅠ.Improved SATRR 2 was used for the treatment of rectocele in groupⅡ.Conventional SATRR was used for the treatment of rectocele in group Ⅲ.The ODS score of each follow-up time point,clinical efficacy,operation time,hospitalization expenses,hospitalization time,postoperative complications were observed and recorded,then we used proper statistical methods to compare and analyze the data.Results:The ODS scores at each follow-up time point of the three groups were significantly decreased compared with the preoperative scores,the difference was statistically significant(group Ⅰ:ta=30.540,30.133,36.852,all P=0.000;group Ⅱ:tb=29.509,32.279,42.298,all P=0.000;group Ⅲ : tc=27.112,35.721,40.799,all P=0.000).There was no significant difference in the ODS scores between three group at each follow-up time points,the difference was not statistically significant(F=0.107,0.094,0.129,0.123;P=0.899,0.910,0.879,0.884).In terms of the clinical efficacy,the hospitalization time,and the incidence of postoperative complications,the difference was not statistically significant(all P>0.05).In terms of the operation time and hospitalization expense,patients in group Ⅰ were less than patients in group Ⅱand group Ⅲ,the difference was statistically significant(all P<0.01).Conclusion:Compared with the other two kinds of surgery,improved STARR 1 is effective,safe and feasible in the treatment of RC,it also has the advantages of shorter operation time,less surgical injury,lower cost of treatment,it is a good choice in the treatment of rectocele.