保留结肠的盲直肠端侧吻合术治疗结肠慢传输型便秘

目的探寻结肠慢传输型便秘创伤较小的手术方法。方法对 12例经结肠传输试验诊断为结肠慢传输型便秘的患者施行盲直肠端侧吻合术 ,将结肠病变肠段旷置而不作次全或全部切除 ,术后观察患者便秘的缓解情况 ,并与行结肠次全切除、盲直肠端端吻合术的 3 4例患者作对照。结果治疗组手术均成功 ,术中时间平均 85分钟 ,失血量 72 .7ml,术后无肠梗阻出现 ,大便 1～ 3次 /d ;对照组手术成功 3 3例 (1例因肠吻合口梗阻 ,次日行结肠造口 ) ,术中时间平均174分钟 ,失血量 3 10ml,大便 1～ 5次 /d ;两组均随访 1年 ,无症状复发者。结论保留结肠的盲直肠端侧吻合术治疗结肠慢传输型便秘疗效确切 ,创伤小 ,手术时间短 ,值得临床推广

Colonic slow transit constipation treated by end-to-side cecorectostomy with colon kept

Objective To study the surgical method of treating colonic slow transit constipation with slight injury.Methods 12 cases diagnosed as colonic slow transit constipation by test of colonic transit were treated by end to side cecorectostomy with colon kept.The lesion section of colon was exposed but not resected or subtotally resected.The signs like constipation were observed after operation and compared with that in subtotal colectomy combined with end to end cecorectostomy in 34 cases.Results The operation was successful in treatment group,with average time of 85 minutes and 72.7 ml loss of blood.After operation,no intestinal obstruction happened.Every day the patients had 1 3 times of bowel movements.In control group,33 cases were successful in operation(one was operated next day because of intestinal stoma obstruction)with average time of 174 minutes,310 ml loss of blood and 1 5 times of bowel movements every day.The follow up in both group was 1 year till no symptoms recurred.Conclusion End to side cecorectostomy with colon kept is effective in treating colonic slow transit constipation with less injury and short operation time,which is worth spreading in clinic.