慢性特发性便秘的原发性乙状结肠切除术和阑尾造口术
Primary sigmoidectomy and appendicostomy for chronic idiopathic constipation.
作者信息
De La Torre Luis, Cogley Kimberly, Calisto Juan, Nace Gary, Correa Catalina
机构信息
Colorectal Center for Children at Children's Hospital of Pittsburgh of University of Pittsburgh Medical Center, One Children's Hospital Drive, 4401 Penn Avenue, Faculty Pavilion Suite 7135, Pittsburgh, PA, 15224, USA.
出版信息
Pediatr Surg Int. 2016 Aug;32(8):767-72. doi: 10.1007/s00383-016-3913-2. Epub 2016 Jul 2.
PURPOSE
To present our experience in patients with chronic idiopathic constipation complicated by megarectosigmoid and fecal incontinence who underwent a primary sigmoidectomy and appendicostomy.
METHODS
We reviewed eight patients referred to the Colorectal Center from 2014 to 2016 with chronic idiopathic constipation and undergoing a sigmoidectomy and appendicostomy. We analyzed the previous medical treatment, indications for the surgical procedure, and outcomes.
RESULTS
Age at operation was 5-19 years. Time with constipation was 4-15 years. All patients received multiple laxatives, mainly polyethylene glycol, and all had severe social problems. Four patients have autism. The indication for surgery was an unsuccessful laxative trial, refusal to continue with rectal enemas or both, and social fear of continued fecal incontinence. Post-operatively, all patients were having daily bowel movements without fecal accidents.
CONCLUSION
Selected patients with chronic idiopathic constipation complicated by megarectosigmoid and fecal incontinence can obtain great benefit from primary sigmoidectomy and appendicostomy.
目的
介绍我们对慢性特发性便秘合并巨乙状结肠和大便失禁患者行一期乙状结肠切除术和阑尾造口术的经验。
方法
我们回顾了2014年至2016年转诊至结直肠中心的8例慢性特发性便秘患者，这些患者接受了乙状结肠切除术和阑尾造口术。我们分析了先前的治疗情况、手术指征及结果。
结果
手术年龄为5至19岁。便秘时间为4至15年。所有患者均接受过多种泻药治疗，主要是聚乙二醇，且均存在严重的社会问题。4例患者患有自闭症。手术指征为泻药试验失败、拒绝继续直肠灌肠或两者皆有，以及对持续大便失禁的社会恐惧。术后，所有患者均每日排便且无大便失禁情况。
结论
部分慢性特发性便秘合并巨乙状结肠和大便失禁的患者可从一期乙状结肠切除术和阑尾造口术中获益良多。
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