Laparoscopic total colectomy via natural orifice specimen extraction surgery for treating colonic slow transit constipation
[Objectives] To investigate the effectiveness of laparoscopic total colectomy via natural orifice specimen extraction surgery (NOSES) for treating colonic slow transit constipation (STC). [Methods] This was a retrospective analysis of 26 patients with STC treated at the Department of Anorectal Surge...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | zho |
| Published: |
Editorial Office of Journal of Colorectal & Anal Surgery
2022-04-01
|
| Series: | 结直肠肛门外科 |
| Subjects: | |
| Online Access: | https://jcas.gxmuyfy.cn/cn/wqll/paper.html?id=435&cateName=2022%E5%B9%B4%20%E7%AC%AC28%E5%8D%B7%20%E7%AC%AC2%E6%9C%9F |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| Summary: | [Objectives] To investigate the effectiveness of laparoscopic total colectomy via natural orifice specimen extraction surgery (NOSES) for treating colonic slow transit constipation (STC). [Methods] This was a retrospective analysis of 26 patients with STC treated at the Department of Anorectal Surgery, The First People’s Hospital of Foshan, between January 2016 and September 2020. All patients underwent laparoscopic total colectomy via NOSES. Intraoperative blood loss, duration of surgery, length of resected intestine, time to postoperative food intake, time to the first postoperative flatulence, duration of postoperative hospitalization, complications at 1 month after surgery, pathology, gastrointestinal quality of life score, the Wexner constipation score, the Patient Assessment of Constipation Symptoms (PAC-SYM) score, the Wexner incontinence score, the Bristol stool scale, and the number of bowel movements were recorded. [Results] All surgeries were uneventful. There was no death related to the surgery, conversions to open surgery, or conversions to take specimen through abdominal wall incision. The mean (SD) duration of surgery was 240 (34) min. The mean (SD) intraoperative blood loss was 56 (12) mL. The mean (SD) length of resected intestine was 30 (12) cm. The mean (SD) time to the first postoperative flatulence was 3.6 (1.2) days. The mean (SD) time to postoperative food intake was 4.1 (1.3) days. The mean (SD) duration of postoperative hospitalization was 7.9 (2.1) days. There were no severe complications such as anastomotic leakage or abdominal infection. Eleven (42.3%) patients had severe diarrhea with daily bowel movements of over ten times. Three (11.5%) patients had postoperative adhesive intestinal obstruction, all of which were relieved after conservative treatment. Pathology of resected intestine showed that 12 had marked reduction of ganglion cells, with an overall rate of 46.1% (12/26). Three months after surgery, the gastrointestinal quality of life score increased significantly, and the Wexner constipation score and PAC-SYM score decreased significantly compared with before surgery (P<0.05). The Wexner incontinence score, the Bristol stool scale and the number of bowel movements 3 months after surgery were significantly less than 1 week after surgery (P<0.05). [Conclusion] Laparoscopic total colectomy via NOSES is effective for treating colonic STC. It is associated with improved bowel movement and quality of life. It has a large potential for wider clinical applications. |
|---|---|
| ISSN: | 1674-0491 |