腹腔镜直肠乙状结肠部分切除联合直肠前突缝合术治疗重度出口梗阻型便秘的临床效果  

The clinical effect of laparoscopic partial rectal and sigmoid resection combined with rectocele suture for severe outlet obstruction constipation

作　　者：范克锋 王萍 黄玉萍 于涛德 FAN Ke-feng;WANG Ping;HUANG Yu-ping(Department of General Surgery,People s Hospital of Chengyang District,Qingdao 266109,China)

机构地区：[1]青岛市城阳区人民医院

出　　处：《腹腔镜外科杂志》2019年第10期774-777,共4页Journal of Laparoscopic Surgery

摘　　要：目的:评价腹腔镜直肠乙状结肠部分切除联合直肠前突缝合术治疗重度出口梗阻型便秘的临床效果。方法:将2014年1月至2018年3月120例确诊为重度出口梗阻型便秘的患者分为两组,实验组(n=60)行腹腔镜直肠乙状结肠部分切除联合直肠前突纵行柱状缝合术,对照组(n=60)行吻合器痔上黏膜环切术联合直肠前突纵行柱状缝合术,分析围手术期数据及手术疗效。结果:实验组患者均顺利完成手术,术中、术后无严重并发症发生,手术时间[(100.5±27.2)min vs.(52.4±18.3)min]、术后住院时间[(6.4±1.1)d vs.(2.4±0.7)d]长于对照组(P<0.05),术后排气时间、围手术期并发症两组差异无统计学意义(P>0.05)。随访1年,对照组患者术后出现肛门下坠感及吻合口狭窄的趋势更明显,实验组Wexner评分[(4.5±1.6)vs.(7.2±2.1),P<0.05]低于对照组,便秘改善优于对照组。结论:腹腔镜直肠乙状结肠部分切除联合直肠前突纵行柱状缝合术治疗重度出口梗阻型便秘安全、可靠,效果良好,值得临床推广。Objective:To evaluate the clinical effect of laparoscopic partial rectal and sigmoid resection combined with rectocele suture for severe outlet obstruction constipation.Methods:One hundred and twenty patients with severe outlet obstruction constipation from Jan.2014 to Mar.2018 were divided into 2 groups.In the experimental group,60 patients underwent laparoscopic rectal and sigmoid resection combined with rectocele longitudinal columnar suture.In the control group,60 patients underwent procedure for prolapse and hemorrhoids(PPH)combined with rectocele longitudinal columnar suture.Analyses were performed to compare perioperative parameters and surgical outcomes.Results:All 60 patients in the experimental group underwent laparoscopic surgery successfully without severe intraoperative or postoperative complications.The operation time[(100.5±27.2)min vs.(52.4±18.3)min]and postoperative hospital stay[(6.4±1.1)d vs.(2.4±0.7)d]of the experimental group were more than those of the control group(P<0.05).No significant difference was observed in postoperative bowel movement recovery or perioperative complications between the two groups(P>0.05).The patients were followed up for 1 year.The trend of anal drop and anastomotic stenosis was more obvious in patients of the control group,the Wexner score of the experimental group was lower than that of the control group[(4.5±1.6)vs.(7.2±2.1),P<0.05],and the improvement of constipation was better than that of the control group.Conclusions:Laparoscopic partial rectal and sigmoid resection combined with rectocele longitudinal columnar suture for severe outlet obstruction constipation is safe and reliable,can be widely used in clinical practice.

关 键 词：重度出口梗阻型便秘 腹腔镜检查 乙状结肠直肠部分切除术 直肠前突柱状缝合术 

分 类 号：R657.1[医药卫生—外科学]