摘要
目的探讨腹腔镜次全结肠切除术(SC)治疗顽固性慢传输型便秘(STC)的疗效。方法收集2017年5月至2023年8月在苏州大学附属第一医院47例明确诊断为慢传输型便秘并行腹腔镜SC治疗的患者围手术期及随访资料,包括手术时间、术中出血量、首次排便时间,以及术前术后的Wexner便秘评分(WCS)和自发排便次数(SCBM)变化等。结果47例患者平均手术时间(266.09±77.72)min,术中出血量100(100,200)mL,预防性造口3例;首次离床时间2(1,3)天,首次进食时间3(2,4)天,首次排便时间3(3,4)天;术后并发症8例,其中术后肠梗阻2例,术后吻合口漏和出血各3例。术前WCS评分18(16,20)分,术后WCS评分4(3,4)分,分值明显下降(Z=5.979,P<0.05);术前SCBM为1(0,1)次/天,术后为3(2,3)次/天,次数明显上升(Z=6.028,P<0.05)。结论腹腔镜SC治疗顽固性慢传输型便秘疗效肯定、创伤小、并发症少,是较理想的外科治疗方法。
Objective To evaluate the effectiveness of laparoscopic subtotal colectomy(SC)in the treatment of intractable slow transit constipation(STC).Methods Clinical and follow-up data of 47 patients with intractable STC treated by laparoscopic SC in the First Affiliated Hospital of Soochow University from May 2017 to August 2023 were collected and retrospectively analyzed in this study.Operation time,intraoperative blood loss,first defecation time,and pre-and post-operative number of Wexner constipation score(WCS)and spontaneous complete bowel movement(SCBM)were analyzed.Results The average operation time of the 47 patients was(266.09±77.72)min,the intraoperative blood loss was 100(100,200)mL,three cases had prophylactic ileostomy;the first time of leaving bed was 2(1,3)d,the first time of feeding was 3(2,4)d,the first time of defecation was 3(3,4)d;there were 8 postoperative complications,including 2 cases of postoperative ileus,three case of postoperative anastomotic hemorrhage and leakage.The preoperative WCS score was 18(16,20)points,and the postoperative WCS score was 4(3,4)points,with a significant decrease in scores(Z=5.979,P<0.05);the preoperative SCBM was 1(0,1)times/day,and the postoperative SCBM was 3(2,3)times/day,with a significant increase in frequency(Z=6.028,P<0.05).Conclusion Laparoscopic SC is an ideal surgical treatment method for the treatment of intractable STC with certain efficacy,minimal trauma,and few complications.
作者
邰清亮
施波
侍新宇
陈国梁
陈俊杰
武冠廷
王索
孙金兵
顾闻
叶建新
何宋兵
Tai Qingliang;Shi Bo;Shi Xinyu;Chen Guoliang;Chen Junjie;Wu Guanting;Wang Suo;Sun Jinbing;Gu Wen;Ye Jianxin;He Songbing(Department of General Surgery,the First Affiliated Hospital of Soochow University,Suzhou 215006,China;Department of General Surgery,Suzhou Ninth People's Hospital,Suzhou 215200,China;Department of General Surgery,Jiangsu Shengze Hospital,Suzhou 215228,China;Department of General Surgery,Changshu No.1 People's Hospital,Suzhou 215501,China;Department of Gastroenterology,The First Affiliated Hospital of Soochow University,Suzhou 215006,China)
出处
《中华结直肠疾病电子杂志》
2023年第6期478-483,共6页
Chinese Journal of Colorectal Diseases(Electronic Edition)
基金
苏州市姑苏卫生重点人才项目(No.GSWS2020005)
苏州市医工结合协同创新研究项目(No.SLJ2021007)。
关键词
便秘
顽固性便秘
慢传输型便秘
腹腔镜次全结肠切除术
疗效观察分析
Constipation
Intractable constipation
Slow transit constipation
Laparoscopic subtotal colectomy
Curative effect analysis
