腹腔镜手术治疗成人结肠冗长症疗效分析

Clinical effects of laparoscopic surgery for adult redundant colon

目的：探讨腹腔镜全结肠切除术治疗成人结肠冗长症的临床效果。方法：回顾分析2011年4月至2013年4月为7例结肠冗长症患者行腹腔镜手术治疗的临床资料。5例伴有顽固性便秘,2例伴便秘与腹泻交替症状,且经X线钡剂灌肠确诊为全结肠冗长症。结果：7例均顺利完成结肠切除术,最后以回肠末端同直肠上端直接吻合。术后未发生严重并发症。术后住院6~9 d,平均（7.8±1.5）d。随访9~24个月,平均（15.0±4.5）个月,疗效均满意,生活质量明显改善,未出现长期腹泻及肠梗阻、便秘复发等远期并发症。结论：X线钡剂造影检查结合长期的顽固性便秘病史是现阶段结肠冗长症诊断的理想方式。应用腹腔镜全结肠切除术治疗成人结肠冗长症疗效确切,具有患者创伤小、康复快、安全有效等优点,但应严格掌握手术适应证。

Objective ： To explore the clinical efficacy of laparoscopic total colectomy in the treatment of the adult redundant co- lon. Methods ：The clinical data of 7 patients with redundant colon who underwent laparoscopic operation during Apr. 2011 and Apr. 2013 were retrospectively analyzed. Of the 7 patients,intractable constipation were found in 5 patients, constipation alternatively with di- airhea in 2 patients, and the redundant colon was diagnosed by barium enema. Results： All cases underwent colectomy with anastomosis of terminal ileum and upper rectum. The procedures were completed successfully in all the cases, and there were no severe postoperative complications. Patients were discharged from hospital in 6 to 9 d with a mean of （7.8 ± 1.5 ） d after the surgery. The time of postopera- tive follow-up was 9-24 months with a mean of （ 15.0 ± 4.5 ） months. The curative effect was satisfactory in all the cases, and there was a significant improvement in quality of life. There were no late operative complications such as long-term diarrhea, intestinal obstruction, recurrent constipation and so on. Conclusions ： A history of intractable constipation and barium enema are the mainstay for the diagnosis of adult redundant colon. The effectiveness of laparoscopic surgery for the treatment of adult redundant colon is ideal, with minimal inva- sion, quick recovery and high safety. The indications of surgical treatment should be strictly mastered.