关键词: 直肠前突, 直肠黏膜柱状缝合, 聚桂醇注射, 排便功能, 术后并发症

Abstract:

Objective To assess the clinical efficacy and safety of rectal mucosal columnar suturing （Block technique） in combination with lauromacrogol injection for the treatment of female rectocele. Methods This retrospective study analyzed 90 female patients with rectocele who were treated at Sir Run Run Hospital， Nanjing Medical University， from January 2022 to December 2023. Patients were categorized into three groups according to their surgical treatments： Block combined with lauromacrogol injection （BP group， n = 30）， Block alone （B group， n = 30）， and Procedure for Prolapse and Hemorrhoids （PPH， H group， n = 30）. The study compared general clinical data， perioperative indicators， Longo′s Obstructed Defecation Syndrome （Longo′s ODS） scores， the degree of rectocele before and after surgery， anorectal manometry parameters， surgical efficacy， and perioperative complications among the three groups. Results The intraoperative blood loss in Group H was significantly higher compared to Groups B and BP （P < 0.05）. In terms of the 24?hour postoperative VAS score and hospital stay duration， Group BP demonstrated superior outcomes relative to Groups H and B （P < 0.05）. Preoperatively， there were no significant differences among the three groups regarding Longo′s ODS score， rectocele depth， resting anal pressure， or residual anal pressure （P > 0.05）. Postoperatively， Group BP exhibited significantly better Longo′s ODS scores and rectocele depth compared to Groups B and H （P < 0.05）. Although no significant differences were observed in postoperative resting and residual anal pressures among the three groups （P > 0.05）， the values in Group BP were closer to the normal range. The overall efficacy rate in Group BP was 93.3%， which was higher than the 73.3% in Group B and 66.7% in Group H （P < 0.05）. There was no significant difference in the complication rate across the three groups （P > 0.05）. Conclusions Block combined with lauromacrogol injection is a safe and effective treatment for female rectocele， demonstrating superior efficacy compared to both PPH and Block alone. This method not only effectively restores the physiological anatomy of the female rectum but also significantly improves clinical symptoms.

Key words: rectocele, rectal mucosal columnar suture, lauromacrogol injection, defecation function, postoperative complications