Outcomes after surgery for refractory constipation patients complicated with megacolon
10.3760/cma.j.issn.1671-0274.2014.05.011
- VernacularTitle:外科手术对顽固性便秘并继发性巨结肠的疗效研究
- Author:
Weiwei DING
1
;
Jun JIANG
;
Xiaobo FENG
;
Anlong YAO
;
Jianlei LIU
;
Ning LI
;
Jieshou LI
Author Information
1. 210002,南京军区南京总医院 南京大学医学院附属金陵医院 全军普通外科研究所
- Keywords:
Constipation;
Megacolon;
Colectomy;
Anastomosis
- From:
Chinese Journal of Gastrointestinal Surgery
2014;(5):453-456
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the efficacy of different procedures for refractory constipation complicated with megacolon. Methods Clinical data of 112 patients of refractory constipation complicated with megacolon undergoing surgery in our institute from June 2007 to January 2013 were retrospectively analyzed. Of these 112 patients, the duration of constipation ranged from 4 to 22 years. Seventy-four patients had previous abdominal operations. Surgical procedures:(1)Jinling procedure (subtotal colectomy plus ascending colorectal posterior wall side-to-side anastomosis , n=81), including 24 laparoscopy-assisted procedures, 18 terminal ileostomies. (2)total colectomy plus ileorectal side-to-side anastomosis (n=18). (3)total colectomy plus end ileostomy, and ileorectal posterior wall side-to-side anastomosis 6 months later (n=13). The end ileostomy was reversed 6 months after operation. Results The successful rate was 100% , and no surgery-related deaths were found. Postoperative complications included early diarrhea (90 cases, 80.4%), anal pain and incomplete evacuation (22 cases, 19.6%), urinary retention within 24-48 h after catheter removal (16 cases, 14.2%), anastomosis bleeding (9 cases, 8.0%), anastomosis leakage (6 cases, 5.4%),and intestinal obstruction (15 cases, 13.4%). Six patients with intestinal obstruction underwent adhesiolysis, and others were managed by conservative therapy. At the postoperative follow-up at 6 months , the Wexner constipation score was significantly reduced (5.8-8.3 vs. 21.4-28.7,P<0.01), and malnutrition improved as well. Conclusion Surgical intervention results in good efficacy for refractory constipation complicated with megacolon.
