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首页> 外文期刊>Surgical Endoscopy >Laparoscopic total colectomy for colonic inertia: surgical and functional results.
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Laparoscopic total colectomy for colonic inertia: surgical and functional results.

机译：腹腔镜全结肠切除术治疗结肠惰性：手术和功能结果。

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BACKGROUND: Total colectomy is the surgery of choice for colonic inertia (CI) when medical treatment has failed. Laparoscopic total colectomy has demonstrated to be a feasible technique. OBJECTIVE: Present our experience in patients with CI who underwent laparoscopic total colectomy (TC) + ileorectoanastomosis (IRA) and evaluate the functional results and medium-term follow-up after this surgery. MATERIAL AND METHODS: All patients with CI were included in a prospective laparoscopic surgical protocol, from 2002 to 2007. These patients had a complete work-up for chronic constipation (clinical records, barium enema, colonic transit time, defecography, anorectal manometry, small bowel follow through). All patients were evaluated with Wexner's score for constipation pre- and postoperatively, asked if they would recommend surgery to other patients, and if they were satisfied with the procedure (on a scale from 1 to 10). Statistical analysis was carried out using Student's T-test. RESULTS: In this period 20 patients were operated with diagnosis of CI. All patients were females with an average age of 41.5 years (range 18-52 years). Mean operative time was 248 min (range 170-360 min). One (5%) patient was converted to open surgery. The medium time to flatus per anum and feeding was 2 (range 1-6) and 3 (range 2-6) days, respectively. The medium postoperative stay was 7 days. Seven patients (35%) presented surgical postoperative complications (three postoperative ileus, one portal thrombosis, one rectal hemorrhage, one anastomotic leakage, and one hemoperitoneum). There was no postoperative mortality. The average follow-up was 25 months (range 1-60 months). Preoperative Wexner's constipation score was 22.3 (range 19-29 months) pre surgery and at the end of follow-up was 1.8 (range 0-6) (p < 0.01). The medium level of satisfaction was 8 (range 2-10) and only one patient would not recommend surgery to other patients. CONCLUSION: The laparoscopic access is a safe technique with satisfactory functional results after medium-term follow-up.
机译：背景：当药物治疗失败时，全结肠切除术是选择结肠惰性手术的首选手术。腹腔镜全结肠切除术已被证明是一种可行的技术。目的：介绍我们在接受腹腔镜全结肠切除术（TC）+回肠直肠吻合术（IRA）的CI患者中的经验，并评估该手术后的功能结果和中期随访。材料与方法：从2002年至2007年，所有CI患者均纳入了前瞻性腹腔镜手术方案。这些患者对慢性便秘进行了完整检查（临床记录，钡剂灌肠，结肠运输时间，排便检查，肛门直肠测压，小排便）。对所有患者进行术前和术后便秘的韦克斯纳评分评估，询问他们是否建议其他患者手术，以及他们是否对手术满意（从1到10）。使用学生的T检验进行统计分析。结果：在此期间，有20例患者被诊断为CI。所有患者均为女性，平均年龄为41.5岁（18-52岁）。平均手术时间为248分钟（范围为170-360分钟）。一名（5％）患者转为开放手术。每年肠胃胀气和进食的中位时间分别为2天（1-6岁）和3天（2-6岁）。术后中等停留时间为7天。 7例（35％）患者出现了手术后并发症（3例术后肠梗阻，1例门静脉血栓形成，1例直肠出血，1例吻合口漏和1例腹膜出血）。没有术后死亡率。平均随访时间为25个月（范围1-60个月）。术前术前韦克斯纳的便秘评分为22.3（范围为19-29个月），随访结束时为1.8（范围为0-6）（p <0.01）。中级满意度为8（范围2-10），只有一名患者不会推荐其他患者手术。结论：腹腔镜手术是一种安全的技术，中期随访后可取得令人满意的功能结果。

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