腹腔镜全结肠及上段直肠切除治疗重度慢传输型便秘

Via Laparoscope Resection of Whole Colon and Upper Rectum in the Treatment of Severe Slow Transit Constipation

为探讨腹腔镜全结肠及上段直肠切除治疗重度慢传输型便秘的临床疗效，对重度慢传输型便秘患者9例采取腹腔镜全结肠及上段直肠切除，7例采取回肠“J”形储袋一直肠吻合，2例回肠一直肠吻合，术后均行肛门功能锻炼，对其临床疗效进行回顾性分析。结果显示，术后随访2年，9例术后1个月平均每日大便频数6．2次（4～12次），呈稀糊状；术后3个月平均每日4．6次（2．2～6．8次），呈稀糊状伴部分软便；术后6个月平均每日3．5次（1．3～4．5次），呈软便偶伴稀糊便；术后1年平均每日1．8次（0．8～3．8次），呈软便；术后2年平均每日1．5次（0．8～2．2次），呈软便。9例术后便秘症状完全改善，生活质量得到明显提高。术后患者排便满意度达90％以上。结果表明，腹腔镜全结肠及上段直肠切除能安全有效地治疗重度慢传输型便秘，术后患者有良好的排便习惯，极大地提高了患者的生活质量。

This study was to investigate the clinical effect of via laparoscope resection of whole colon and upper rectum in the treatment of severe slow transit constipation（STC）.The 9 cases of this constipation received above surgery among whom 7 were subjected to the anastomosis of ileum J pouch to rectum,2 to the anastomosis of ileum to rectum;after surgery all patients practiced anal function exercise. Authors retro- spectively analyzed their clinical effect.As results,the postoperative follow-up of 2 years found that all of 9 patients at 1 month, daily average defecation frequency was 6.2 times（4 12 times）, consistency of stools was paste-like; at 3 months, 4.6 times/d （2.2-6.8 times）, paste-like associated with part soft stools; at 6 months, 3.5 times/d（1.3-4.5 times）, soft stools seldom associated with paste-like ; in one year, 1.8 times/d （0.8-3.8 times）,soft stools;in 2 years, 1.5 times/d（0.8-2.2 tims）,soft stools.In a word, after surgery their constipation symptoms got improved gradually and completely, the quality of life also significantly lifted, so that patient＇s satisfactory degree to defecation was up tO more than 90 %. Results show that above-mentioned procedure can safely and effectively treat severe STC, with better defecation habit, thus patient＇s quality of life get greatly lifted.