Colonic Pseudo-Obstruction with Distinct Transitional Zone in Adult Constipation Patients: Pathological Analysis and Results of Surgical Treatment
Colonic Pseudo-Obstruction with Distinct Transitional Zone in Adult Constipation Patients: Pathological Analysis and Results of Surgical Treatment
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成人便秘患者明显移行区假性结肠梗阻的病理分析及手术治疗结果
DOI：
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发表时间：
2011
期刊：
影响因子：
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通讯作者：
K. Park
中科院分区：
文献类型：
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作者：
E. Choe;Sung;K. Park
慢性便秘患者的亚群表现出结肠假性梗阻（CPO）的特征，并具有明显的移行带（TZ）。我们的目的是分析这些患者的临床病理特征和手术结果。在9年的时间里，对25例连续的便秘手术患者进行了分析。TZ（+）组：手术时有大肠梗阻的症状或体征，TZ周围近端结肠扩张、远端结肠塌陷，但无机械性梗阻的证据。19例（76%）患者具有TZ的CPO特征。所有TZs均位于左结肠。病理学上，所有TZ（+）患者的TZ均发现节段性神经节细胞减少症。另一方面，病理诊断为B型肠神经元发育不良，其余6例（24%）患者具有均匀的结肠直径，没有明显的异常（TZ（-）组）。在TZ（+）患者中，17例（90%）行全结肠切除回肠直肠吻合术，2例（10%）行肠造口术。长期随访（中位数56个月）显示该组患者无便秘复发。所有6名TZ（-）患者均接受了全结肠切除术和回肠直肠吻合术，其中2名（33%）患者在长期随访（中位60个月）时出现持续性便秘症状。在一个亚组的成年便秘患者的特点CPO与TZ，节段性神经节细胞减少症是最终的病理诊断。因此，具有CPO特征且左结肠存在明显TZ的患者有望从手术干预中获益。
There are subsets of chronic constipation patients showing features of colonic pseudo-obstruction (CPO) with distinct transitional zone (TZ). We intended to analyze the clinicopathologic characteristics and surgical outcomes of these patients. Twenty-five consecutive patients who underwent surgery for constipation over the 9-year period were analyzed. TZ (+) group was defined as patients showing symptoms or signs of large bowel obstruction with dilated proximal and collapsed distal colon around the TZ at the time of operation, but without any evidence of mechanical causes of obstruction. Nineteen (76%) patients had features of CPO with TZ. All TZs were located in the left colon. Pathologically, segmental hypoganglionosis was identified at the TZ in all TZ (+) patients. On the other hand, pathologic diagnosis was intestinal neuronal dysplasia type B in the remaining six (24%) patients having a uniform colon diameter without demonstrable dilatations (TZ (-) group). Among TZ (+) patients, 17 (90%) underwent total colectomy with ileorectal anastomosis and two (10%) underwent enterostomy. Long-term follow-up (median 56 months) showed no recurrence of constipation in this group of patients. All six TZ (-) patients underwent total colectomy with ileorectal anastomosis and two (33%) of them had persistent symptoms of constipation on long-term follow-up (median 60 months). In a subset of adult constipation patients presenting with features of CPO with TZ, segmental hypoganglionosis was the final pathologic diagnosis. Constipation patients with features of CPO with distinct TZ in the left colon are expected to benefit from surgical intervention.
影响因子：
29.4
作者：
He, CL;Burgart, L;Farrugia, G
通讯作者：
Farrugia, G