慢传输型便秘外科治疗进展

Progress of surgical treatment for slow transit constipation

慢传输型便秘（slow transit constipation,STC）是指结肠的传输功能障碍,肠内容物传输缓慢所引起的便秘,症状为大便次数减少,便意消失,伴腹胀。随着时间的推移其症状逐渐加重,严重影响患者的生活质量和身心健康。近年来随着生活质量的提高,STC的发病率有升高的趋势,占慢性便秘的16%~40%。目前,在STC的外科治疗中,国外多采用全结肠切除回直肠吻合术,其次采用次全结肠切除盲直肠吻合术,少数文献报道了顺行结肠灌洗和回肠造口术;

The most common procedures of surgical treatment for slow transit constipation （STC） are total colectomy with ileorectal anastomosis, and subtotal colectomy with caeco-rectal anastomosis. The subtotal colectomy is the main procedure in China. The effective rates of both procedures account for higher than 85%. Colon exclusion, which was only reported by Chinese surgeons, has significant shortages though being applied widely. It needs extensive clinical observation and investigation. Colonic irrigation, ileostomy, and total colec- tomy with ileoanal anastomosis are not suggested as regular surgeries. For patients with STC, strict conservative treatments should be applied before surgery. Surgery should be applied only when the conservative treatments fail. The patients who combined with psychiatric symptoms need special treatment. If surgery is needed, optimal procedures should be selected cautiously.