慢传输型合并出口梗阻型便秘的手术治疗

The operation methods and therapeutic effectiveness in the treatment of chronic slow-transit and outlet obstructive constipation

目的评估结肠次全切除逆蠕动盲肠直肠吻合术联合其它手术方法治疗特发性慢传输型合并出口梗阻型便秘的疗效。方法对1999-12～2004-12求治的15例单纯慢传输性便秘患者和108例慢传输型合并出口梗阻型便秘患者行结肠次全切除逆蠕动盲肠吻合术和结肠次全切除逆蠕动盲肠吻合术联合出口梗阻的手术治疗,术后随访其排便情况及治疗效果。结果术后平均随访4年,无严重并发症和病死;术后排便满意者达85.4%,所有患者生活质量明显改善。结论对慢传输性合并出口梗阻型便秘患者,在结肠次全切除逆蠕动盲肠直肠吻合术同时对不同病因的出口梗阻型便秘进行联合手术治疗,临床效果理想。

Objective To evaluate the effectiveness of subtotal coleetomy with ceeorectal anastomosis （SCCA） in the treatment of slow-transit and outlet obstructive constipation （OOC）. Methods The 15 patients underwent SCCA only for slow-transit constipation （STC） and 108 underwent SCCA and other types of operation for slow-transit constipation （STC） and OOC. Results All the 123 patients were administered a questionnaire, ineluding the eontition of bowl movement and therapeutic efficacy. There was no mortality or major postoperative complications. All the patients reported a good or improved quality of life, 85.5% of patients satisfied with the defecation. Conclusion For patients with STC and OOC, the effection of subtotal colectomy with eeeoreetal anastomosis （SCCA） accompanied with other types of operation for OOC is satisfactory.