Feasibility study of HRCM preoperative assessment combined with NOSES Jinling surgery in the treatment of slow transit constipation
10.3760/cma.j.cn441530-20241224-00423
- VernacularTitle:高分辨率结肠测压联合经自然腔道取出标本金陵术治疗慢传输型便秘的临床分析
- Author:
Jiaqi KANG
1
;
Mingsen LI
;
Chen XU
;
Yongjun YU
;
Yuwei LI
;
Zhao ZHANG
Author Information
1. 天津市人民医院 南开大学第一附属医院肛肠外科，天津 300121
- Publication Type:Journal Article
- Keywords:
Slow transit constipation;
High resolution colon manometry;
Natural orifice specimen extraction surgery;
Laparoscopic Jinling surgery
- From:
Chinese Journal of Gastrointestinal Surgery
2025;28(12):1455-1460
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the feasibility of employing high-resolution colon manometry (HRCM) in conjunction with natural orifice specimen extraction surgery (NOSES) during laparoscopic Jinling surgery for the treatment of colonic slow transit constipation (STC).Methods:This study retrospectively analyzed data from nine patients with STC who underwent HRCM preoperative evaluation and subsequently received NOSES Jinling surgery at Tianjin Union Medical Center between October 2016 and March 2023. The general intraoperative conditions and postoperative evaluation indicators were recorded.Results:All 9 patients underwent HRCM examination before surgery. High amplitude propagation contraction (HAPC) was observed in the ascending colon segment of all patients. The occurrence frequency of HAPC was 4.22±1.86 (times/day). The operation time of 9 patients was 200.0 (167.5, 250.0) minutes, the intraoperative blood loss was 100 (50, 150) ml, the postoperative hospitalization time was 13.0 (12.5, 24.0) days, and the first postoperative exhaust time was 3.0 (2.0, 3.5) days, the first postoperative defecation time was 5.0 (4.5, 5.5) days, the first postoperative eating time was 5.0 (5.0, 5.5) days, and the first postoperative time out of bed was 5.0 (5.0, 8.0) days. Notably, none of the 9 patients experienced postoperative complications. The Wexner scores at 6 months [5 (4, 7)], and 12 months [4 (3, 5)] post-surgery were significantly lower than the preoperative score [20 (16, 21)] ( P<0.05). Additionally, the patient assessment of constipation quality of life (PAC-QOL) scores at 6 months [22 (20, 25)], and 12 months [18 (12, 45)] after surgery showed a significant decrease compared to preoperative scores [79 (72, 82)] ( P<0.05). Conclusions:The combination of HRCM preoperative assessment and NOSES Jinling surgery is both safe and feasible for the treatment of slow transit constipation, warranting further development and promotion.
