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Efficacy and safety of combined use of subtotalcolectomy and modified Duhamel procedure in the surgical treatment of severe functional constipation
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- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF GASTROINTESTINAL SURGERY
- Issue:
- 2
- DOI:
- 10.3760/cma.j.issn.1671-0274.2007.02.004
- Key Word:
- 重度功能性便秘;外科手术;结肠次全切除术;改良Duhamel术;生活质量
Abstract： 目的 探索临床上较为满意的治疗重度功能性便秘(SFC)的手术方式.方法 分析2000年9月至2005年4月间50例SFC患者经结肠次全切除与改良Duhamel联合术式治疗的临床资料.结果 50例曾予以严格的非手术治疗效果欠佳.经过结肠镜、结肠传输试验和排粪造影等检查,显示有明确的病理解剖和功能性异常部位后,均施行了结肠次全切除与改良Duhamel联合手术治疗.术后病理检查:27例(54%)结肠肌萎缩;29例(58%)结肠肌间丛细胞减少,神经纤维排列紊乱有缠结现象.全组术后随访(2.4±1.2)年,胃肠生活质量指标、便秘症状指标和出口功能指标均明显改善,44例(88%)患者对其排便感到满意,仅有9例(18%)诉轻度腹痛;3例(6%)有不同程度的腹泻,无大便失禁;2例(4%)有轻度便秘复发,应用膨胀性泻剂和促动力药后症状可缓解.结论 结肠次全切除与改良Duhamel联合术式是治疗SFC较为合理、效果较好的手术方案.
- [1]中华医学会消化病学分会.慢性便秘的诊治指南[J].2004,(1).
- [2]E E, Soffer.Constipation: an approach to diagnosis, treatment, referral.[J].1999,66.
- [3]Keighley.Surgical management of chronic constipation[J].1999,1(4).
- [4]R M, Mollen,H C, Kuijpers,A T, Claassen.Colectomy for slow-transit constipation: preoperative functional evaluation is important but not a guarantee for a successful outcome.[J].2001,44(4).
- [5]Delaney,Kirwan.A double-stapled anastomosis to facilitate colorectal anastomosis in the Duhamel operation[J].1999,1(2).
- [6]Lahr, Stepanie J.,Lahr, Christopher J..Operative Management of Severe Constipation.[J].1999,65(12).
- [7]W G, Thompson,G F, Longstreth,D A, Drossman,etc.Functional bowel disorders and functional abdominal pain.[J].1999,45 Suppl 2.
- [8]Aldulaymi BH,Rasmussen OO,Christiansen J.Long-term results of subtotal colectomy for severe slow-transit constipation in patients with normal rectal function.[J].2001,3(6).
- [9]A, Alves,B, Coffin,Y, Panis.[Surgical management for slow-transit constipation].[J].2004,129.
- [10]N A, Rotholtz,S D, Wexner.Surgical treatment of constipation and fecal incontinence.[J].2001,30(1).
- [11]J A, Ryan,W C, Oakley.Cecoproctostomy.[J].1985,149(5).
- [12]E. Eypasch,J. I. Williams,S. Wood-Dauphinee,etc.Gastrointestinal Quality of Life Index: Development, validation and application of a new instrument[J].1995,82(2).
- [13]Kamm M. A.Constipation and its management[J].2003.
- [14]Gabrio Bassotti,Giuseppe Chiarioni,Italo Vantini,etc.Anorectal manometric abnormalities and colonic propulsive impairment in patients with severe chronic idiopathic constipation[J].1994,39(7).