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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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