经脐单孔SILS-Port腹腔镜结肠次全切除术治疗慢传输型便秘10例报告  

Transumbilical SILS-Port Laparoscopic-assisted Subtotal Colectomy for Slow Transit Constipation:Report of 10 Cases

作　　者：龚文敬[1] 赵希忠[1] 任叔阳[1] 安辉[1] 蓝海波[1] 赵美珠[1] 杨向东[1] 

机构地区：[1]成都肛肠专科医院便秘科,成都610015

出　　处：《中国微创外科杂志》2017年第1期72-75,88,共5页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨经脐单孔SILS-Port腹腔镜结肠次全切除术治疗慢传输型便秘的安全性与可行性。方法 2014年12月~2015年6月我院采用经脐单孔SILS-Port腹腔镜结肠次全切除术治疗慢传输型便秘10例,记录术后疼痛及腹壁美容满意度评分,采用Wexner便秘评分、便秘症状严重程度评分和胃肠生活质量指数评价便秘治疗的疗效。结果均顺利完成手术,手术时间(217±35)min,术中出血量(36±11)ml。均无术后出血、吻合口漏、腹腔感染、肠梗阻及肛门失禁等并发症发生。首次排气、排便时间分别为(2.4±0.8)d和(2.9±0.6)d,术后切口疼痛VAS评分(3.3±0.5)分,术后腹壁美容满意度评分(4.3±0.5)分。术后6个月Wexner便秘评分(4.5±1.0)分,显著低于术前(22.0±1.9)分(t=26.087,P=0.000);便秘症状严重程度评分(5.5±0.5)分较术前(23.2±0.9)分,明显降低(t=52.836,P=0.000);胃肠生活质量指数(105.7±3.9)分,较术前(77.4±6.0)分明显提高(t=-12.457,P=0.000)。结论经脐单孔SILS-Port腹腔镜结肠次全切除术治疗慢传输型便秘安全可行,腹壁美容效果好,近期疗效满意。Objective To explore the safety and feasibility of transumbilical SILS-Port laparoscopic-assisted subtotal colectomy for treating slow transit constipation. Methods Clinical data of 10 patients with slow transit constipation who underwent transumbilical SILS-Port laparoscopic-assisted subtotal colectomy in our hospital were analyzed. The postoperative pain and abdominal beauty satisfaction score,Wexner constipation score,constipation severity score and gastrointestinal quality of life index（ GIQLI） were recorded to evaluate the treatment efficacy. Results All the operations were completed successfully without postoperative complications,such as postoperative bleeding,anastomotic fistula,abdominal infections,intestinal obstruction and incontinence. The operative time was（ 217 ± 35） min,the blood loss was（ 36 ± 11） ml,the first time of exhaust and defecation were（ 2. 4 ± 0. 8） d and（ 2. 9 ± 0. 6） d,the postoperative pain and abdominal beauty satisfaction scores were（ 3. 3 ± 0. 5） points and（ 4. 3 ± 0. 5） points. The Wexner constipation score and symptom severity score were（ 4. 5 ± 1. 0） points and（ 5. 5 ± 0. 5） points,which were significantly lower than preoperative scores（ t = 26. 087,P = 0. 000; t = 52. 836,P = 0. 000）. The GIQLI was（ 105. 7 ± 3. 9） points,which was significantly higher than that before operation [（ 77. 4 ± 6. 0） points,t =- 12. 457,P = 0. 000]. Conclusion Transumbilical SILS-Port laparoscopic-assisted subtotal colectomy for slow transit constipation is a safe and feasible procedure with good cosmetic satisfaction and excellent short-term effects.

关 键 词：经脐单孔SILS-Port 经自然腔道内镜手术 腹腔镜 结肠次全切除术 慢传输型便秘 

分 类 号：R656.9[医药卫生—外科学]