Menguy R, Chey W
Faculté de Médecine, Université de Rochester, Genesee Hospital, Rochester, NY 14607, USA.
Chirurgie. 1993;119(9):525-9.
We review current experience with surgical treatment of severe constipation due to primary inertia of the colon. Over the last 10 years, we have operated 18 patients (14 females and 4 males) with severe constipation. The surgical procedure was either nearly total colonectomy with ascending colon/rectum anastomosis (8 cases) or total colonectomy with ileorectal anastomosis (9 cases). In one patient, coloproctectomy was performed with an ileoanal anastomosi. Indications for surgery were based on results of barium emena and functional evaluation of defecation. Results were satisfactory in all patients. In several patients however, we noted that the motility of other levels of the digestive tract was also impaired. Colonectomy was introduced as a treatment for chronic constipation nearly a century ago and although very few indications have been retained in the recent this procedure has now become an acceptable surgical approach in a limited number of well-though-out cases.
我们回顾了因结肠原发性惰性导致的严重便秘的外科治疗的当前经验。在过去10年中，我们对18例严重便秘患者（14名女性和4名男性）进行了手术。手术方式为升结肠/直肠吻合的近全结肠切除术（8例）或回直肠吻合的全结肠切除术（9例）。1例患者行结肠直肠切除术并回肠肛管吻合术。手术指征基于钡灌肠结果和排便功能评估。所有患者的结果均令人满意。然而，在一些患者中，我们注意到消化道其他部位的蠕动也受到了损害。结肠切除术作为慢性便秘的一种治疗方法在近一个世纪前就已引入，尽管近年来保留的指征很少，但在少数经过充分考虑的病例中，该手术现已成为一种可接受的手术方法。
