Subtotal Colectomy、ascending Colon Rectum Anastomosis And Total Colectomy、the Ileum Rectal Anastomosis Retrospective Study For The Treatment Of STC

Constipation is a common gastro-intestinal diseases, as well as a variety of symptoms that may occur during the process of disease development. Constipation are clinical frequently-occurring disease, the epidemiological survey results show that the incidence of constipation at home and abroad more than 3%, the incidence of constipation in the elderly more than 35% higher. In recent years, with the progress of the aging population, life rhythm speeding up, the increase of the fine food intake in the diet, constipation number also increased year by year, has become the stubborn disease of people’s living standard. According to difference of constipation of the-patho-genic factors, clinical will be divided into slow both trans-missive constipation(colon underpowered, contents by slow), outlet obstruction constipation and mixed constipation. This study explores the slow both transmissive constipation hold(STC).Slow both transmissive constipation belongs to functional constipation. Because of its stubborn illness, easy to relapse, but also gradually worse as time goes by, is clinically refractory disease. Due to the slow transit constipation patients exist serious colon pathological change, intestinal ganglia to reduce or missing, therefore tend to have poor medical conservative treatment, surgical treatment become a final choice on STC patients. In recent years, with the deepening understanding of the disease, clinical operation of treatment on STC in varied, but what kind of operation can achieve better clinical curative effect, there is no unified conclusion. Looking for a better clinical effect, less trauma, less postoperative complications, postoperative quality of life and better operation, is the main direction of our current research.Objective: A retrospective analysis of the line through Subtotal colectomy 、Ascending colon rectum anastomosis and Total colectomy 、 The ileum rectal anastomosis colonic slow transit constipation treatment curative effect(STC) of patients, comparing these two surgical treatment of colonic slow transit constipation(STC) differences in bowel function and quality of life of patients explore the surgical treatment of colonic slow transit constipation optimal surgical procedures.Method: The 40 patients were included in the standard, in accordance with the line of the different methods of surgery were divided into group A: Subtotal colectomy、Ascending colon rectum anastomosis, and group B: Total colectomy、The ileum rectal anastomosis in groups. Detailed records in the two groups before the history data, and integral condition defecation self-assessment, and one month, three months respectively after discharge telephone follow-up record postoperative curative effect evaluation, defecate score, postoperative gastrointestinal life quality score and presence of complications.Result: 1. The clinical curative effect comparison: Postoperative 1 month return results: the total effective rate of group A was 82.35%, B group total effective rate was 86.95%, the effectiveness is better than that of group A and group B was statistically significant(P < 0.05); 3 months after return results: the total effective rate of group A was 82.35%, B group total effective rate was 91.30%, the effectiveness is better than that of group A and group B was statistically significant(P < 0.05); 2. After one month follow-up wexner anal incontinence score: group A: 6.35 ± 1.11, group B is: 1.11 ±0.72(p < 0.01) significant statistical significance. Three months after return visit wexner anal incontinence score: group A: 5.64± 0.94, group B is: 0.94 ±0.94(p < 0.01) significant statistical significance. Group B patients postoperative incontinence, less is better than that of group A; 3. The gastrointestinal life quality score(GIQLI) group A after A month as follows: 99.41 ± 6.33, group B is: 95.30±5.53(P < 0.05) was statistically significant. Three months after review: group A: 86.82± 6.48, group B is: 6.48±7.68(P < 0.05) was statistically significant. In terms of improve the postoperative quality of life, is better than that of group A, group B and the forward curative effect is better.Conclusion: For colon slow transit constipation patients, Subtotal colec-tomy、Ascending colon rectum anas-tomosis, and Total colec-tomy、The ileum rectal anas-tomosis can improve constipation symptoms, improve quality of life, has the good clinical curative effect.But in the case of strictly grasp the indications, Subtotal colec-tomy、Ascending colon rectum anas-tomosis which has better clinical effect.