腹腔镜结肠切除术治疗慢性传输型便秘的临床体会

Clinical experience of laparoscopic colectomy for slow transit constipation

目的：探讨腹腔镜治疗慢性传输型便秘（slowtransit constipation,STC）的临床效果。方法：回顾分析2006至2009年施行腹腔镜手术治疗23例STC患者的临床资料。8例行全结肠切除术,10例行结肠次全切除术,5例行乙状结肠切除术。结果：22例手术成功,1例因术中出血中转开腹。住院5-11d,平均7d。术后1例并发肠梗阻,经保守治疗不能缓解,再次行开腹手术治愈。随访6-12个月,18例便秘症状明显缓解,大便1-3次/d;3例腹泻,大便4-6次/d;2例轻度便秘复发,大便1次/2-3d。结论：腹腔镜结肠切除术治疗STC安全有效,且住院时间短,患者康复快,切口小,并发症少,腹部外观好,值得推广应用。

Objective：To investigate the clinical effects of laparoscopic treatment of slow transit constipation（STC）.Methods：Retrospective analysis was made on the clinical data of 23 STC patients who underwent laparoscopic surgery from 2006 to 2009.Eight patients underwent total colectomy,10 cases received subtotal colectomy,5 patients were performed sigmoid colon resection.Results：Twenty-two operations were successful,one case was converted to laparotomy for bleeding.Their hospital stay was 5-11d,with an average of 7d.In all of them one patient complicated by postoperative intestinal obstruction,which could not be relieved by conservative treatment,and cured by re-laparotomy.After operations all patients were followed up for 6-12 months.Symptoms of 18 cases were relieved（stool frequency of 1-3 times/d）,2 cases of mild constipation relapsed（stool frequency of 1 time/2-3d）,3 patients got diarrhea（stool frequency of 4-6 times/d）.Conclusions：Laparoscopic colectomy for STC is safe and effective,with short hospital stay,quick recovery,small incision,less complications,and better cosmetic results.It is worthy to be applied.