摘要目的 探讨腹腔镜结肠次全切除、逆蠕动盲肠直肠吻合术在治疗结肠慢传输型便秘中的临床应用价值.方法 2007年9月至2010年10月对收治的31例结肠慢传输型便秘患者进行腹腔镜结肠次全切除、逆蠕动盲肠直肠吻合术,术后3个月和12个月进行随访,以评定手术效果.结果 全组患者手术均成功,无中转开腹手术,手术时间平均260 min(180～310 min),术中出血量平均60 ml(30～120 ml),术后平均住院日8 d(6～11 d),无吻合口瘘、粘连性肠梗阻、切口及腹腔内感染等手术近期并发症.术后3个月随访,便秘症状明显缓解23例,轻度腹泻5例,腹泻2例,症状轻度复发1例.术后12个月随访,便秘症状明显缓解25例,轻度腹泻5例,症状轻度复发1例.结论 腹腔镜结肠次全切除、逆蠕动盲肠直肠吻合术治疗结肠慢传输型便秘,具有创伤小、术后恢复快的优势,临床安全有效,值得临床运用.

abstractsObjective To investigate the clinical application value of laparoscopy-assisted subtotal colectomy with antiperistalsis cecorectal anastomosis for slow transit constipation (STC).Methods From September 2007 to October 2010,a total of 31 patients with STC underwent laparoscopic-assisted subtotal colectomy with antiperistalsis cecorectal anastomosis.A follow-up survey was completed at 3 and 12 months after the operation.Results No death or conversions to open operation occurred.The mean operation time,mean intraoperative blood loss and mean post-operative hospitalization were 260 min (180-310 min),60 ml (30-120 ml) and 8d (6-11 d),respectively.No postoperative infection,anastomotic stoma,adhesive intestinal obstruction or other perioperative complications occurred.In 3-month follow-up,constipation was significantly alleviated in 23 patients,mild diarrhea occurred in 5,diarrhea in 2 and mild recurrence in 1.Constipation was significantly alleviated in 25 patients,mild diarrhea occurred in 5 and mild recurrence in 1 at 12-month follow-up.Conclusion Laparoscopy-assisted subtotal colectomy with antiperistalsis cecorectal anastomosis is safe,effective and less invasive for STC.