【摘要】 目的评估结肠次全切除逆蠕动盲-直吻合术治疗慢传输型便秘的疗效。方法采用结肠次全切除逆蠕动盲-直吻合术治疗17例,其中特发性慢传输型便秘14例,慢传输型合并出口梗阻型便秘2例, 特发性巨结肠1例。评估患者术后排便情况、并发症、生活质量。结果术后1个月平均每天大便次数5 (3-7)次,半液体状大便;术后1年平均每天大便次数3(2-4)次,固体状大便;术后2年平均每天大便次数2 (1-4)次。术后所有患者均不需用止泻药;1例混合型便秘患者仍间断使用泻药外其余患者均未用泻药。17 例患者(100％)术后生活质量得到明显改善。术后2例出现粘连性小肠梗阻,其余患者未出现腹泻、腹痛、腹部不适等并发症。结论对部分慢传输型便秘及特发性巨结肠患者,结肠次全切除逆蠕动盲-直吻合术是一种安全、有效的术式。更多还原

【Abstract】 Objects To evaluate the clinical effects after subtotal colectomy with antiperistaltic cecop-roctostomy.Methods We retrospectively analyzed 17 patients who underwent subtotal colectomy with antiperi-staltic cecoproctostomy. The patients included idiopathic chronic slow-transit constipation , mixed chronic constipation , and idiopathic megacolon. Number of bowel movement, stool consistency; complications, and quality of life were evaluated. Results There was no mortality or major postoperative morbidity. One month after the operation, bowel frequency was a mean of 5(range, 3-7) per day, with a semiliquid stool consistency. After 1 year, bowel frequency was a mean of 3(range, 2-4) per day, with a solid stool consistency. After 2 years, bowel frequency was a mean of 2(range,1-4) per day. Although no patients used antidiarrheal medicine, laxatives continued to be used by one patient with mixed chronic constipation. All patients (100%) reported a good or improved quality of life. A patient had adhensive ileus postoperatively. At a mean 30-monthfollow-up (range, 24-36 ), no patients showed diarrhea or incontinence, and were compeletely relieved from previous symptoms and abdominal discomfort. Conclusion Subtotal colectomy with end-to-end antiperistaltic cecoproctostomy seems to be a safe and effective procedure for selected patients with idiopathic chronic slow-transit constipation and idiopathic megacolon.更多还原