Observation On Short-term Therapeutic Effect On Subtotal Colectomy For Treatment Of Slow Transit Constipation

With the development of society progresses, the population aging, the pressure of people's life increasing, and the structure of people's diet and lifestyle changed, constipation has become a serious diseases which impacts on people's quality of life. Slow transit constipation is one type of constipations. The treatment of slow transit constipation, such as diet, lifestyle, medication, psychological therapy, traditional Chinese medicine therapy, acupuncture treatment, surgery are multiformity. But because that the slow transit constipation has serious changes in the colon pathophysiology, The internal medicine treatment results are often ineffective, so more patients resort to surgery. Abroad, the operation of total colectomy is often used, while in our country the operation of sub-total colectomy is often used , but how long the retain of the cecum and rectum is no uniform conclusions. Therefore, the reports of postoperation efficacy in quite different.Objective: To evaluate short-term therapeutic effect on subtotal colectomy for treatment of slow transit constipation (STC), in order to provide clinical evidence for subtotal colectomy with cecoproctostomy in STC.Methods: Between September 2007 and May 2009, 30 patients with STC underwent subtotal colectomy with cecoproctostomy.To Compare the indicators of constipation symptoms before and after operation in patients ,the following information was collected during following-up(1 month, 6 months, 12 months): condition of defecation, complications, quality of life and degree of satisfaction.Results: After operation ,the condition of the patients who suffered from defecation difficulties, long defecation time, bearing down and abdominal distension, defecation frequency and stool consistency were significantly improved. On the followed up observation ,1 month after operation defecation frequency in patients was an average of 4-5 times / day, then it returned to normal in 1 year. The symptoms of rectal discomfort in 20 patients were no significant improvement after surgery, but they were disappeared in 1 year. 1 month after surgery abdominal pain,abdominal distention occurred in 3 cases, diarrhea and antidiarrhoeal drug were used in 1 case, but after 12 months, the symptoms mentioned above were disappeared .After 12 months, 30 patients were recovered well without incontinence, constipation, recurrent small bowel obstruction, intestinal fistula and other complications and degree of satisfaction was 100%. Resection of the specimen were researched, and the colon pathology showed that most of the cases had less the myenteric plexus ganglion cells. The cases with the residual ganglion cell degeneration were 93.3%, and the cases with mucosal chronic inflammation were 90%.Conclusion: 1. The observation of indicators reflected that subtotal colectomy for slow transit constipation significantly can improve symptoms of constipation.2. By 1 year follow-up observation in patients, 30 patients except some suffered from short-term diarrhea, abdominal pain, abdominal distention were all recovered well without serious complications, the constipation symptoms in patients were basic improved and the degree of satisfaction was 100%.If we obey the indications strictly in slow transit constipation surgical operation, subtotal colectomy for slow transit constipation get good effect.