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摘要
The aim of this study was to evaluate outcomes of total colonic exclusion with antiperistaltic ileorectal anastomosis (TCE-AIA) for elderly patients with slow transit constipation (STC). Elderly patients (defined as age > 65) who underwent TCE-AIA for severe idiopathic STC between 2009 and 2012 at our institution were identified. Postoperative outcomes and routine follow-up were assessed using the Wexner constipation score (WCS), gastrointestinal quality of life index (GIQLI) and four-point postoperative satisfaction scales. A total of 13 elderly patients were met the inclusion criteria. Five patients (38.5 %) were male, and eight patients (61.5 %) were female. The mean age of this population was 74 years (range 63-82 years). The mean operative time was 55 min (range 28-32), and blood loss was minimal. The mean postoperative hospital stay was 6.7 days (range 5-12 days). The mean time until the first postoperative bowel movement was 4 days (range 2-8 days). There was no procedure-related mortality and no major in-hospital complications. The median duration of follow-up was 12.4 months (range 6-29 months). None of the 13 patients had fecal incontinence or recurrence of constipation at the follow-up end point. However, eight patients underwent colonoscopy during follow-up, and four patients presented with diversion colitis. The patients' preoperative WCS was 22.8 +/- A 3.3, and it had significantly improved to 5.4 +/- A 2.1 on 6 months after operation (p < 0.05). The preoperative GIQLI of 93.6 +/- A 20.5 had significantly increased to 120.8 +/- A 13.0 on 6 months after surgery (p < 0.05). Patient satisfaction at 6 months was very high in 11 patients and high in two patients. TCE-AIA is a relatively simple procedure. It might be an effective surgical intervention for the selected elderly patients with STC.
- 出版日期2014-7
- 单位武汉大学
