腹腔镜结肠次全切除逆蠕动盲直肠吻合术治疗慢传输型便秘

Laparoscopically assisted subtotal colon resection with antiperistalsis cecorectal anastomosis for chronic slow-transit constipation

目的评价腹腔镜结肠次全切除逆蠕动盲直肠吻合术治疗结肠慢传输型便秘的疗效。方法对2007-06～2008-08入住全军肛肠外科研究所的34例慢传输型便秘患者行腹腔镜下结肠次全切除逆蠕动盲直肠吻合术。术后随访患者恢复情况。结果术后随访1年,所有患者无严重并发症和死亡,该组患者手术时间170～230min,平均185min;出血量30～120ml,平均60ml;术后32h肠蠕动恢复,48h下床活动,住院时间为9～14d,平均11d;切口平均长度5.4(4.5±0.8)cm,术后1年排便1～2次/d,为成形软便,术后患者排便满意率达90%以上。结论腹腔镜下结肠次全切除逆蠕动盲直肠吻合术治疗结肠慢传输型便秘,手术切口小、出血少、创伤小、痛苦小、住院时间短、并发症少、临床效果好,是一种理想的手术方式。

Objective To evaluate the surgical outcomes of laparoscopy in subtobal colectomy with cecorectal anastomosis in the treatment of slow-transit constipation. Method Between June 2007 and August 2008, 34 patients underwent laparoscopy of subtotal colectomy with cecorectal anastomosis in the treatment of slow-transit constipation. Result All the cases were operated on successfully.No conversions to open surgery were needed and no dead occurred. The average operative time was 185±38min. The volume of bleeding during operation was from 30 to 120ml, mean 60±32ml in these patients. The function of intestine was come to within mean 32h. The average hospital ization stay was lid, no one had severe complication; 90% of the patients had satisfied for the defecation. Conclusion Laparoscopic-assisted subtotal colectomy for chronic slow-transit constipation is a safe and effective technique, and better than classical laparotomy in minimally invasive surgery features, and should be advocated actively.