成人结肠冗长症的外科治疗

Surgical Treatment of Adult Dolichocolon

目的:探讨成人结肠冗长症的诊断和手术治疗效果。方法:回顾分析复旦大学附属第五人民医院2000年2月—2010年2月收治的24例成人结肠冗长症患者的临床资料。结果:24例患者中,行乙状结肠切除者14例,其中通过腹腔镜辅助乙状结肠切除者8例;横结肠切除者3例;降结肠、乙状结肠切除,将脾曲横结肠向下游离与直肠上端吻合3例;横结肠、降结肠、乙状结肠切除,再将横结肠右半拉下与直肠上端吻合者2例;全结肠切除,回肠末端与直肠上端吻合者2例。结论:根据顽固性便秘病史和X线钡剂灌肠透视或仿真肠镜检查结果可确诊成人结肠冗长症。外科手术治疗该病效果确切,有症状者应尽早手术治疗。

Objective：To investigate the efficacy of surgical treatment in adult dolichocolon. Methods：The clinical data of 24 patients with adult dolichocolon were analyzed retrospectively. Results： Among the 24 patients, 14 cases underwent sigmoidec- tomy, 8 patients of whom underwent laparoscope assisted sigmoidectomy; 3 cases underwent transverse colon resection; 3 ca- ses underwent descending colon and sigmoid colon resection; 2 cases underwent transverse,descending and sigmoid colon resec- tion, while 2 cases underwent pancolectomy with anastomosis of terminal ileum and upper rectum. During a follow-up period of 6 months to 3 years, the curative effects were satisfied in all cases. Conclusions： A medical history of intractable constipation and X-ray barium enema or CT emulational endoscope are helpful for the diagnosis of dolichocolon, and surgery is an effective way to treat intractable constipation caused by adult dolichocolon.