Alves A, Coffin B, Panis Y
Service de chirurgie digestive, hôpital Lariboisière, 2, rue Ambroise-Paré, 75010 Paris, France.
Ann Chir. 2004 Oct;129(8):400-4. doi: 10.1016/j.anchir.2004.07.003.
Less than 10% of patients with slow-transit constipation require surgical management after failure of medical treatment. Preoperative clinical, psychological and colorectal routine investigations (ie colonic transit test, anorectal manometry and defecography) are mandatory in order to highly select the patients. To day, the surgical management of slow-transit constipation consists of subtotal colectomy with ileorectal anastomosis, eventually by laparoscopic approach. Although, surgical management improves slow-transit constipation in two thirds of the patients, small bowel obstruction, abdominal pain and constipation recurrence can occur in 25%, 50%, and 10% of the patients respectively.
慢传输型便秘患者经药物治疗失败后，需要手术治疗的不到10%。术前进行临床、心理和结直肠常规检查（即结肠传输试验、肛门直肠测压和排粪造影）是必要的，以便严格筛选患者。目前，慢传输型便秘的手术治疗包括次全结肠切除回直肠吻合术，最终可采用腹腔镜手术。尽管手术治疗可使三分之二的患者的慢传输型便秘得到改善，但分别有25%、50%和10%的患者会出现小肠梗阻、腹痛和便秘复发。
