Clinical Study Of Stapled Suprahemorrhoids Mucosal Circumcision Combined With Internal Sphincter Release In The Treatment Of Rectocele

Objective:To investigate the clinical effect of procedure for prolapse and hemorrhoids(PPH)combined with internal sphincterolysis in the treatment of rectocele.Methods:On the basis of the operation method,60 female patients who conformanced the diagnostic criteria of rectocele from the Second Affiliated Hospital of Hunan University of traditional Chinese medicine were divided into experimental group and control group by random number table method.The experimental group was treated with PPH combined with internal sphincterolysis,while the control group was treated with PPH for 3 months,of which 30 cases in each group were actually observed.The clinical efficacy,obstructed defecation syndrome(ODS)score,Rectocele depth,anorectal manometry and complications of the two groups were compared and analyzed.Results:1.Before treatment,there was no significant difference in age,course of disease,ODS score,norectal manometry and the severity of rectocele between the two groups(P>0.05).2.Clinical efficacy:1 month after operation,he total effective rate of PPH combined with internal sphincterolysis group and PPH group was 100%;Three months after operation,the total effective rate of PPH combined with internal sphincterolysis group was 9 0 %,and that of PPH group was 80%;There was significant difference in clinical efficacy between the two groups at 1 month and 3 months after operation(P<0.05).3.ODS score:the comparison of ODS score between the two groups at 1 month and 3 months after operation,and the differences were statistically significant(P<0.05);The ODS scores of the two groups at 1 month and 3 months after operation were compared with those before operation,and the difference was statistically significant(P<0.05);4.Anorectal manometry:there was no significant difference in anal longest contraction time,anorectal pressure difference and rectal resting pressure between the two groups(P>0.05);The difference between the two groups in analmaximum contraction pressure and anal resting pressure was statistically significant(P<0.05);There was no significant difference in anal longest contraction time and rectal resting pressure between the two groups(P>0.05);There were significant differences in anal maximum contraction pressure,anorectal pres sure difference and anal resting pressure between the two groups(P<0.05);Anorectal manometry at 1 month and 3 months after operation was compared with that before operation in the two groups:tanal longe stcontraction time and rectal resting pressure in the two groups were compared,and the difference was not stat istically significant(P>0.05);The difference between the two groups in anal maximum contraction pressure,anorectal pressure difference and anal resting pressure was statistically significant(P<0.05);5.Rectocele depth:there was no significant difference in rectocele depth between the two groups 3 months after operation(P>0.05);6.Postoperative complications:there were no serious complications such as anal stenosis,rectovaginal fistula and anal incontinence in the two groups.Conclusion:PPH combined with internal sphincterolysis in the treatment of rectocele has definite clinical effect,can significantly improve the constipation symptoms of patients,safe,no serious complications,simple operation,it is worthy of clinical promotion.