Application Of Hand-Assisted Laparoscopic Surgery (HALS) In Slow Transit Constipation (STC)

ObjectiveTo compare the curative effect between hand-assisted laparoscopic surgery(HALS) and open surgery in subtotal colectomy, and to evaluate the safety and feasibility of hand-assisted laparoscopic subtotal-colon or total colon resection.Methods140patients of Slow Transit Constipation (STC), were divided randomly into two groups,which were HALS(68patients) and open group (72patients) with retrospectively analysis. Comparisons were focused on clinical manifestation, colon transmission test (CTT),defecography, operating time, blood loss, postoperative anal exhaust time, postoperative anal exhaust time, mean postoperative hospital stay, early postoperative complications to postoperative follow-up defecation.ResultsThe clinical data between HALS group and convential laparotomy group was not significantly different. All the140patients were treated by subtotal colectomy. In terms of operating time, convential laparotomy group was significantly shorter than that of HLAS group (160±12min vs198±15min). The clinical features,blood loss(250±12ml vs230±30ml) was similar for the two groups. Incision lenghth(5.7±1.1cm vs25.2±4.5cm),uses of analegesics(2.2±0.8vs3.0±1.5),postoperative anal exhaust time(73.4±3.6h vs92.5±5.3h), mean postoperative hospital stay(8.0±3.9d vs14.2±5.1d) were better in HLAS group than in open group. One case of Incision dehiscence,four of incision infection and two intestinal obstruction were found in in the open group,No complication occurred in HALS group.Patients were followed up for6-24months,in the meantime the average defecating frequency was2.65±1.7/d.ConclusionHand-assisted laparoscopic surgery(HALS) of subtotal colectomy was proved to be more safe, more effective. It has better operational appearance, and fewer early postoperative complications, postoperative hospital stays, and less invasional injury. On the other hand, it takes more opreation time.