Favorable surgical treatment outcomes for chronic constipation with features of colonic pseudo-obstruction

作     者：Eon Chul Han Heung-Kwon Oh Heon-Kyun Ha Eun Kyung Choe Sang Hui Moon Seung-Bum Ryoo Kyu Joo Park 

作者机构：Department of SurgerySeoul National University College of MedicineSeoul 110-744South Korea Seoul National University Hospital Gangnam CenterSeoul 110-744South Korea 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2012年第18卷第32期

页      面：4441-4446页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Constipation Total colectomy Pseudoobstruction Surgical outcome Hypoganglionosis 

摘      要：AIM:To determine long-term outcomes of surgical treatments for patients with constipation and features of colonic ***:Consecutive 42 patients who underwent surgery for chronic constipation within the last 13 years were prospectively *** identified a subgroup with colonic pseudo-obstruction(CPO) features,with dilatation of the colon proximal to the narrowed transitional zone,in contrast to typical slowtransit constipation(STC),without any dilated colonic *** outcomes of surgical treatments for chronic constipation with features of CPO were analyzed and compared with outcomes for ***:Of the 42 patients who underwent surgery for constipation,33 patients had CPO with dilatation of the colon proximal to the narrowed transitional *** were 16 males and 17 females with a mean age of 51.2 ± 16.1 *** had symptoms of chronic intestinal obstruction,including abdominal distension,pain,nausea,or vomiting,and the mean duration of symptoms was 67 mo(range:6-252 mo).Preoperative defecation frequency was 1.5 ± 0.6 times/wk(range:1-2 times/wk).Thirty-two patients underwent total colectomy,and one patient underwent diverting transverse *** was no surgery-related *** histologic examination showed hypoganglionosis or agangliosis in 23 patients and hypoganglionosis combined with visceral neuropathy or myopathy in 10 *** contrast,histology of STC group revealed intestinal neuronal dysplasia type B(n = 6) and visceral myopathy(n = 3).Early postoperative complications developed in six patients with CPO;wound infection(n = 3),paralytic ileus(n = 2),and intraabdominal abscess(n = 1).Defecation frequencies 3 mo after surgery improved to 4.2 ± 3.2 times/d(range:1-15 times/d).Long-term follow-up(median:39.7 mo) was available in 32 patients;all patients had improvements in constipation symptoms,but two patients needed intermittent medication for management of *** 32 patients had distinct