慢性便秘的外科治疗

Surgical treatment for chronic constipation

便秘可因肠管动力失调、盆腔出口梗阻或二者并存所致。只有少数经保守治疗无效的顽固性便秘患者需要手术治疗。本文对各种手术方式作一综述。次全结肠切除回直肠吻合对结肠无力症效果较好 ,但疗效难以预测。重度的直肠前膨出修补效果较好。全面仔细的术前功能和影象学检查 。

Constipation is related to intestinal motility d isorders,pelvic outlet obstruction or a combination of both. Surgical interventi on is only indicated in a small group of patients with intractable constipation failed to conservative treatment.This paper reviews the surgical options for chr onic constipation.Subtotal colectomy with ileorectal anastomosis is the choice f or colonic inertia,but the result is variable and unpredictable.Repair of severe rectocele may yield a high success rate.Thorough preoperative functional and im age examinations are mandatory for a successful outcome in highly selected patie nts.