结肠次全切逆蠕动盲直肠吻合术治疗成人结肠冗长致顽固性便秘疗效观察

Effect of subtotal colectomy with antiperistaltic cecorectal anastomosis on intractable constipation caused by redundant colon in adults

目的探讨结肠冗长致顽固性便秘成人患者行结肠次全切逆蠕动盲直肠吻合术治疗的临床效果。方法结肠冗长致顽固性便秘成人患者19例,均行结肠次全切逆蠕动盲直肠吻合术,随访观察手术效果。结果 19例均手术成功,术中出血量200~500mL,手术时间110~130min,术后3~5d首次排便,术后10~18d出院;术后发生腹腔出血1例,切口感染2例,胃瘫1例,小肠梗阻1例,腹泻1例,经对症支持治疗后好转;出院后随访3~18个月,1例失访,余患者术后控便能力均良好。结论对成人结肠冗长导致的顽固性便秘,采取结肠次全切逆蠕动盲直肠吻合术治疗效果满意。

Objective To explore the clinical effect of subtotal colectomy with antiperistaltic cecorectal anastomosis on intractable constipation caused by redundant colon in adults. Methods Nineteen adult patients with intractable constipation in adults caused by redundant colon were performed subtotal colectomy with antiperistaltic cecorectal anastomosis.The operation outcome was followed up.Results The surgery was successfully completed in all 19 patients.The intraoperative blood loss was 200 to 500 mL,the operation lasting time was 110 to 130 min,the first postoperative defecation was in 3 to 5 d,and the postoperative hospitalization stay was 10 to 18 d.The complications included abdominal hemorrhage in 1 patient,incision infection in 2,gastroparesis in 1,intestinal obstruction in 1 and diarrhea in 1,all of which were cured by symptomatic and supportive treatment.All patients were followed up for 3 to 18 months after discharge,one patient lost follow-up,and the other patients got fine defecation function after operation.Conclusion The surgery of subtotal colectomy with antiperistaltic cecorectal anastomosis can achieve a satisfactory result for intractable constipation caused by adult redundant colon.