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Preservation of superior rectal artery in laparoscopically assisted subtotal colectomy with ileorectal anastomosis for slow transit constipation

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World Journal of Gastroenterology 2021年第22期27卷 3121-3129页

作者： Chien-Wei Wu Ta-Wei Pu Jung-Cheng Kang Cheng-Wen Hsiao Chao-Yang Chen Je-Ming Hu Kuan-Hsun Lin Tzu-Chiao Lin Department of Surgery Tri-Service General HospitalNational Defense Medical CenterTaipei 11490Taiwan Division of Colon and Rectal Surgery Department of SurgerySongshan BranchTri-Service General HospitalNational Defense Medical CenterTaipei 10581Taiwan Division of Colon and Rectal Surgery Department of SurgeryTaiwan Adventist HospitalTaipei 10556Taiwan Division of Colon and Rectal Surgery Department of SurgeryTri-Service General HospitalNational Defense Medical CenterTaipei 11490Taiwan Division of Colorectal Surgery Department of SurgeryTri-Service General HospitalNational Defense Medical CenterTaipei 11490Taiwan Division of Thoracic Surgery Department of SurgeryTri-Service General HospitalNational Defense Medical CenterTaipei 11490Taiwan

BACKGROUND Slow transit constipation(STC)has traditionally been considered as a functional ***,evidence is accumulating that suggests that most of the motility alterations in STC might be of a neuropathic *** the patient does not meet the diagnosis of pelvic outlet obstruction and poorly response to conservative treatment,surgical intervention with subtotal colectomy may be *** most unwanted complication of the procedure is anastomotic leakage,however,preservation of the superior rectal artery(SRA)may reduce its *** To evaluate the preservation of the SRA in laparoscopically assisted subtotal colectomy with ileorectal anastomosis in STC *** This was a single-center retrospective observational *** was diagnosed after a series of examinations which included a colonic transit test,anal manometry,a balloon expulsion test,and a barium *** patients underwent laparoscopically assisted total colectomy with ileorectal anastomosis and were examined between January 2016 and January *** operation time,blood loss,time to first flatus,length of hospital days,and incidence of minor or major complications were *** A total of 32 patients(mean age,42.6 years)who had received laparoscopic assisted subtotal colectomy with ileorectal artery anastomosis and preservation of the *** patients were diagnosed with STC after a series of *** mean operative time was 151 min and the mean blood loss was 119 *** mean day of first time to flatus was 3.0 d,and the mean hospital stay was 10.6 *** were no any patients conversions to ***-operative minor complications including 1 wound infection and 1 case of *** was no surgical *** anastomosis leakage was noted in any of the *** Laparoscopically assisted subtotal colectomy with ileorectal anastomosis and preservation of the SRA can significantly improve bowel function with careful patient selection

关键词： Slow transit constipation Superior rectal artery Anastomosis leakage Laparoscopic-assisted colorectal surgery Iliorectal anastomosis colonic transit time

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Study on the characteristics of intestinal motility of constipation in patients with Parkinson's disease

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World Journal of Gastroenterology 2021年第11期27卷 1055-1063页

作者： Mei Zhang Shuang Yang Xiao-Cui Li Hong-Ming Zhu Ding Peng Bang-Yi Li Tian-Xu Jia Chen Tian Department of Gastroenterology Xuanwu HospitalCapital Medical UniversityBeijing 100053China National Clinical Research Center for Geriatric Disease Xuanwu HospitalCapital Medical UniversityBeijing 100053China

BACKGROUND Constipation is one of the most important nonmotor symptoms in Parkinson's disease(PD)patients,and constipation of different severities is closely related to the pathogenesis of *** with constipation(PDC)is considered a unique type of constipation,but its mechanism of formation and factors affecting its severity have been less *** the gastrointestinal motility characteristics and constipation classification of PDC patients is essential to guide the treatment of *** this study,the colonic transit test and high-resolution anorectal manometry were used to identify the intestinal motility of PDC to provide a basis for the treatment of *** To investigate the clinical classification of PDC,to clarify its characteristics of colonic motility and rectal anal canal pressure,and to provide a basis for further research on the pathogenesis of *** Twenty PDC patients and 20 patients with functional constipation(FC)who were treated at Xuanwu Hospital of Capital Medical University from August 6,2018 to December 2,2019 were included.A colonic transit test and high-resolution anorectal manometry were performed to compare the differences in colonic transit time,rectal anal canal pressure,and constipation classification between the two *** There were no statistically significant differences in sex,age,body mass index,or duration of constipation between the two *** was found that more patients in the PDC group exhibited difficulty in defecating than in the FC group,and the difference was statistically *** rectal resting pressure,anal sphincter resting pressure,intrarectal pressure,and anal relaxation rate in the PDC group were significantly lower than those in the FC *** proportion of paradoxical contractions in the PDC group was significantly higher than that in the FC *** was a statistically significant difference in the type composition ratio of defecatory disorders between the two groups(P<0.05

关键词： Parkinson's disease Parkinson's disease with constipation colonic transit time High-resolution anorectal manometry

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