A prospective comparison of short term results and functional recovery after laparoscopic subtotal colectomy and antiperistaltic cecorectal anastomosis with short colonic reservoir vs. long colonic reservoir.
A prospective comparison of short term results and functional recovery after laparoscopic subtotal colectomy and antiperistaltic cecorectal anastomosis with short colonic reservoir vs. long colonic reservoir.
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DOI：
10.1186/s12876-015-0257-7
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发表时间：
2015-03-18
影响因子：
2.4
通讯作者：
Cai F
中科院分区：
文献类型：
--
作者：
Wei D;Cai J;Yang Y;Zhao T;Zhang H;Zhang C;Zhang Y;Zhang J;Cai F
目的观察比较腹腔镜结肠次全切除逆蠕动盲肠直肠吻合术（LSCACRA）短结肠贮液囊和长结肠贮液囊治疗成人慢传输型便秘（STC）的近期疗效和功能恢复情况。随访了2007年4月至2011年12月期间在我们机构接受LSCACRA治疗的所有STC患者。保留回盲部上方2 ~ 3cm升结肠为观察组，保留回盲部上方10 ~ 15 cm升结肠为对照组。观察组41例，对照组40例。收集患者的术前和术后转归参数，包括性别、年龄、体重指数、手术时间、出血量、首次排气时间、住院时间、术后并发症、Wexner便秘量表（WCS）、Wexner失禁量表、胃肠道生活质量指数（GIQLI）、腹痛强度量表（APIS）、腹痛频率量表（APFS）和腹胀量表（ABS）。所有患者均顺利完成腹腔镜手术，无中转开腹或手术相关死亡病例。两组手术时间、术中出血量、首次排气时间、住院天数无显著性差异。我们发现两组之间的并发症（Clavien-Dindo分级> I）无显著差异。无患者出现吻合口漏。两组均无大便失禁发生。术后3、6、12个月，除对照组3、6个月APIS外，两组各项指标均较术前明显改善（P < 0.05）。术后3、6、12个月观察组WCS、GIQLI、APIS、APFS、ABS功能恢复结果均上级对照组（P < 0.05）。LSCACRA治疗成人STC疗效显著。通过缩短回盲部以上保留的升结肠长度，可以改善患者的术后效果，提高患者的生活质量。试验注册：中国临床试验注册中心ChiCTR-OPC-14005280，2014-09-29。本文的在线版本（doi：10.1186/s12876-015-0257-7）包含补充材料，可供授权用户使用。
To observe and compare the short term results and functional recovery of laparoscopic subtotal colectomy with antiperistaltic cecorectal anastomosis (LSCACRA) in the treatment of Adult slow transit constipation (STC) with two different reservoir length: short colonic reservoir and long colonic reservoir. All STC patients treated with LSCACRA between April 2007 and December 2011 at our institution were followed up. Patients with 2 cm to 3 cm ascending colon preserved above the ileocecal junction were designated as observation group, whereas those preserved by 10 cm to 15 cm were classified as control group. 41 cases in the observation group and 40 cases in the control group were enrolled. Preoperative and outcome parameters of patients were collected, including gender, age, body mass index, operative time , blood loss, first flatus time, hospital stay, postoperative complications, Wexner constipation scale(WCS), Wexner incontinence scale, gastrointestinal quality of life index(GIQLI), abdominal pain intensity scale(APIS), abdominal pain frequency scale(APFS) and abdominal bloating scale(ABS). Laparoscopic surgeries were successfully carried out for all patients, without any case transferred to laparotomy or death related to surgery. The operative time, blood loss, first flatus time, and days of hospital stay of the two groups did not show significant differences. We found no significant differences on complications (Clavien–Dindo grade > I) between the two groups. No patient exhibited anastomotic leak. No fecal incontinence occurred in both groups. On the 3rd, 6th and 12th month after operation, the parameters of both groups significantly improved compared with the preoperative conditions (P < 0.05) except the APIS at 3rd and 6th month in control group. On the 3rd, 6th and 12th month after operation, the Functional Recovery outcomes of WCS、GIQLI、APIS、APFS and ABS in the observation group were superior to those in the control group (P < 0.05). LSCACRA has a significant effect in the treatment of STC in adult. Postoperative outcomes can be optimized by shortening the length of the preserved ascending colon above the ileocecal junction, which promise better life quality of patients. Trial registration: Chinese Clinical Trial Registry ChiCTR-OPC-14005280, 2014-09-29. The online version of this article (doi:10.1186/s12876-015-0257-7) contains supplementary material, which is available to authorized users.
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DOI：
10.1007/s00464-005-0099-4
发表时间：
2006-01-01
影响因子：
3.1
作者：
Iannelli, A;Fabiani, P;Gugenheim, J
通讯作者：
Gugenheim, J
影响因子：
2.6
作者：
Marchesi, Federico;Sarli, Leopoldo;Roncoroni, Luigi
通讯作者：
Roncoroni, Luigi
影响因子：
3.3
作者：
Sarli, L;Iusco, D;Roncoroni, L
通讯作者：
Roncoroni, L
DOI：
10.1007/s00464-011-2092-4
发表时间：
2012-06-01
影响因子：
3.1
作者：
Marchesi, Federico;Percalli, Luigi;Roncoroni, Luigi
通讯作者：
Roncoroni, Luigi
影响因子：
3.9
作者：
Sarli, L;Costi, R;Roncoroni, L
通讯作者：
Roncoroni, L