经腹腔镜和开腹结肠次全切除术治疗结肠慢传输性便秘的比较

目的:评价经腹腔镜结肠次全切除术的安全性和可行性.方法:回顾对比分析2006年8月至2009年1.月我院手术治疗39例结肠慢传输性便秘患者,分经腹腔镜手术(腹腔镜组)19例和开腹手术(开腹组)20例两组,比较两组病人手术操作用时间、术中出血量、术后肛门恢复排气时间、术后平均住院时间和术后并发症.结果:39例均行结肠次全...

Comparisons of Laparoscopic Surgery and Open Subtotal Colectomy for Slow Transit Constipation

Objective: To assess the safety and feasibility of laparoscopic subtotal colectomy for colonic slow transit constipation. Methods: From August 2006 to October 2009, 39 patients with slow transit constipation in our hospital treated by surgery were divided into laparoscopic surgery group (n=19) and open surgery group (n=20). Clinical data were comparatively analyzed retrospectively between the two groups including operative times, blood loss, time to return of flatus, length of postoperative hospital stay, and complications. Results: All of 39 patients were treated by subtotal colectomy. In laparoscopic surgery group, laparoscopic surgery was performed in 9 cases, hand-assisted laparoscopic surgery was performed in 10 cases, and additional functional uterus rectumsuspension was fixed in 5 cases. In open surgery group, additional functional uterus rectumsuspension was performed in 20 cases, pelvic floor elevated and pelvic floor repaired in 6 cases. The mean operative time for the laparoscopic group was longer than the open group (4.45 h vs 3.46 h, P<0.05). There was no difference in blood loss (101.3 ml vs 163.7 ml), time to return of flatus (3.52 d vs 3.25 d), and length of postoperative hospital stay (14.8 d and 13.7 d). All patients were followed up for 3 to 16 months, the average stool frequence was 2.37 per day. In laparoscopic surgery group, 2 cases with mild abdominal pain were relieved after six months. In open group, 1 case had fat liquefaction, 2 cases with incomplete intestinal obstruction relieved after conservative treatment, and 1 case with relapsed constipation was treated by drug. Nine cases with over 5 times stool every day (5 cases in laparscopic surgery group, 4 cases in open group) were also treated by drug. Conclusion: Both laparoscopic surgery and open subtotal colectomy are safe and effective, but laparoscopic surgery remains mini scars, however the operation time is longer.