结肠慢传输型便秘24例外科治疗体会

摘要

Objective To explore the surgical approach for severe slow transit constipation (STC). Methods The clinical data of 24 patients with severe slow transit constipation subject to surgical treatment were retrospectively analyzed. Results Subtotal colectomy with antiperistaltic cecoproctostomy was performed on 10 cases; Colonic bypass with antiperistaltic cecoproctostomy was performed on 8 cases; Colonic bypass with ileorectal anastomosis was performed on 4 cases ; Colonic bypass with ileosigrnoid anastomosis was performed on 2 cases. There were no major early postoperative complications and perioperative deaths. During a median follow-up of 48 (range 1-96) months, the mean frequency of daily bowel movement was 2 times. The GIQLI score was improved postoperation (P＜0. 01). The outcome was excellent in 13 of 24 patients, good in 7, fair in 3, and poor in 1. Conclusion The selection of surgical approaches should be individualized in patients with STC.%目的 探讨结肠慢传输型便秘(slow transit constipation,STC)病人的合理手术方式.方法 回顾性分析了24例接受手术治疗的结肠STC病人的临床资料.结果 结肠次全切除、逆蠕动盲肠直肠吻合术10例,结肠大部分旷置、逆蠕动盲肠直肠吻合术8例,结肠旷置、回肠直肠吻合术4例,结肠旷置、回肠乙状结肠吻合术2例.无一例手术死亡,术后并发症:切口感染或脂肪液化2例,发生小肠梗阻1例,切口疝1例.术后随访1～96个月(中位48个月),每日大便1～3次(平均2次).术后GIQLI评分显著高于术前(P<0.01).23例便秘症状在术后得到不同程度地改善,1例术后无改善.结论 对于结肠STC病人,应根据病人的具体情况采取相应的手术方式.