腹腔镜结肠次全切除联合改良逆蠕动盲肠直肠吻合术治疗慢传输型便秘的效果

Effects on Laparoscopy Assisted Subtotal Colectomy with Modified Antiperistalsis Ceco-rectal Anastomosis for Slow Transit Constipation

目的探讨腹腔镜结肠次全切除联合改良逆蠕动盲肠直肠吻合术治疗结肠慢传输型便秘的临床效果。方法选取2016年4月至2018年10月河南中医药大学第一附属医院收治的24例结肠慢传输型便秘患者,进行腹腔镜结肠次全切除联合改良逆蠕动盲肠直肠吻合术,术后6个月和12个月随访,以评定手术效果。结果所有患者手术均成功,无中转开腹手术,围手术期无严重并发症及死亡,术后并发肠梗阻2例,经保守治疗痊愈,无吻合口瘘、切口及腹腔内感染等手术近期并发症。术后第6个月数字评估分量表(NRS)、Wexner便秘评分量表(WCS)和胃肠疾病生活质量指数量表(GIQLI)评分与治疗前比较,差异有统计学意义(P<0.05);术后第12个月NRS、WCS及GIQLI评分与治疗前比较,差异有统计学意义(P<0.05);术后第6个月NRS、WCS及GIQLI评分与术后第12个月比较,差异无统计学意义(P>0.05)。结论腹腔镜结肠次全切除联合改良逆蠕动盲肠直肠吻合术治疗结肠慢传输型便秘效果显著,无严重并发症,可改善患者术后便秘症状,提高术后生活质量。

Objective To investigate clinical effects on laparoscopy-assisted subtotal colectomy with modified antiperistalsis ceco-rectal anastomosis for slow transit constipation.Methods A total of 24 patients with slow transit constipation were selected in the First Affiliated Hospital of Henan University of Chinese Medicine From April 2016 to October 2018.All patients underwent laparoscopy-assisted subtotal colectomy with modified antiperistalsis ceco-rectal anastomosis.A follow-up survey was completed at 6 and 12 months after the operation and to evaluate the effects.Results All these patients were successfully completed laparoscopic surgery without conversions to open surgery.There was no mortality or major postoperative morbidity during perioperative period.Two cases of postoperative intestinal obstruction were cured by conservative treatment.No anastomotic leakage,incision and intra-abdominal infection or other perioperative complications occurred.There were differences in numerical rating scale(NRS)score,wexner scores of constipation(WCS)score and gastrointestinal quality of life index(GIQLI)score between the 6 months after operation and before treatment(P<0.05).There were differences in NRS,WCS and GIQLI scores between the 12 months after operation and before treatment(P<0.05).There were no differences in NRS,WCS and GIQLI scores between the 6 months after operation and the 12 months after operation(P>0.05).Conclusion Laparoscopy-assisted subtotal colectomy with modified antiperistalsis ceco-rectal anastomosis in the treatment of slow transit constipation is effective and without severe complications,which can improve the postoperative constipation symptoms and the quality of life.