结肠次全切除及盲肠直肠端侧吻合治疗慢传输型便秘

Subtotal colectomy with cecorectal endside anastomosis in the treatment of slow transit constipation

目的 探讨结肠次全切除及盲肠直肠端侧吻合术治疗结肠慢传输型便秘的可行性.方法 回顾性分析2006年3月至2013年4月间在兰州军区兰州总医院肛肠外科接受结肠次全切除及盲肠直肠端侧吻合术治疗的23例慢传输型便秘患者的临床疗效.结果 23例患者均成功实施手术治疗,术后发生吻合口瘘1例,尿潴留1例;无吻合口狭窄、腹腔内出血、腹腔内疝、肛门失禁等并发症发生.随访2月至7年,排粪次数维持在1～4次/d,无需加用止泻剂,排粪时间均可控制在5 min内,且无便秘症状复发.结论 结肠次全切除及盲肠直肠端侧吻合术是一种治疗结肠慢传输型便秘较为有效的方法.

Objective To study the feasibility of subtotal colectomy with cecorectal endside anastomosis for slow transit constipation.Methods Retrospective analysis was performed on 23 patients with colon slow transit constipation treated by subtotal colectomy with cecorectal endside anastomosis in our department from March 2006 to April 2013.The main measure outcome was the curative effect on constipation by this type of surgery.Results Twenty-three patients were successfully treated.Anastomotic leakage occurred in one case,and urinary retention in 1 case,while no anastomotic stricture,abdominal bleeding,abdominal hernia,incontinence and other complications occurred.During follow-up of 2 months to 7 years,defecation frequency was 1-4 times a day with no need of antidiarrheal agents.Each time of defecation was less than 5 min.All the patients had no recurrence of constipation.Conclusion Subtotal colectomy with cecorectal endside anastomosis can be used to treat colon slow transit constipation,while accurate preoperative evaluation and strict indications for the surgery is the key to success.