Clinical Analysis Of Surgical Procedures(Jinling Procedures)and Basic Research For Slow Transit Constipation

OBJECTIVES:To explore the clinical features and operation indieation of Slow transit constipation and the effeet of surgiealtreatment for Slow transit constipation.Preliminary study of pathogenesis of Slow transit constipation.SUBJECT:From2012.1to2013.4,the clinieal data of9cases with Slow transit constipation treated by operation(Jinling procedures).METHODS:A retrospective analysis of the clinical data of9patients, to compare the clinical effect of operation treatment.Operation resection of the colon were detected by immunohistochemical Cajal method of C-kit positive interstitial cells (ICC) expression, using transmission electron microscopy study on the ultrastructure of interstitial cells of Cajal.RESULTS:No operation-associated death occurred. Increased bowel movement frequency was ob-served during the perioperative period.Complications included small bowel obstruction (33%), anastomotic leakage (11%), and wound infection (11%). Most postoperative complications were managed conservatively. The most recent follow-up was on2011.1, and the follow-up rate was100%at3,6and12months after surgery. GIQLI temporarily increased from78.1±9.4preoperatively to92.0±9.5at3months follow-up,but continued to decrease during the follow-up at the6months (48.4±14.1) and12months (21.0±4.3). Wexner constipation scale decreased from19.9±4.3preoperatively to8.4±2.1at3months follow-up (P<0.01). The low Wexner scale sustained until12months after operation. The satisfaction rate at the3,6and12months fol-low-up was66.7%,77.8%and88.9%.CONCLUSIONS:Surgical procedures is a treatment for STC. Jinling procedure provides refractory constipa-tion patients with a novel, safe and effective surgical option.The numbers of C-kit opsitive ICC were decreased.It may be the mechanism for Slow transit constipation.