Analysis Of Safety And Efficacy Of Laparoscopic Total Colectomy For Colonic Slow Transit Constipation

Objective: To analyze the safety and efficacy of laparoscopic total colectomy for colon slow transit constipation.Methods: The clinical data of 15 patients with slow colonic constipation who underwent laparoscopic total colectomy in the Second Hospital of Jilin University from July 2018 to October 2019 were retrospectively analyzed.The average operative time,intraoperative blood loss and incidence of postoperative complications were counted.The frequency of defecation,Wexner constipation score,Wexner anal incontinence score and Giqli score of preoperative and postoperative 3 months,6 months,9 months and 12 months were counted.SPSS26.0 software was used for statistical analysis of the data to evaluate the safety and efficacy of the operation.Results: The average operation time of the 15 patients was 178±16.12 min,the longest operation time was 210 min,and the shortest operation time was 150 min.The intraoperative blood loss was 168±41.67 min,with the maximum and minimum blood loss of 200 ml and 100 ml.No intraoperative blood transfusion was given.Postoperative incision infection occurred in 2 patients,anastomotic fistula occurred in 1 patient,and mild intestinal obstruction occurred in another patient.No anastomotic bleeding or other complications occurred in all patients,and no readmission patients were reported within 30 days.There was no significant correlation between postoperative anastomotic fistula,incision infection and postoperative intestinal obstruction and gender,age and operation time(P > 0.05).The frequency of postoperative defecation was increased,and the difference was statistically significant(P < 0.05).The average frequency of postoperative defecation was 1-3 times/day after 1 year.Postoperative constipation score of patients decreased gradually with time,and the difference was statistically significant(P < 0.05).Postoperative GIQLI score of patients increased gradually,and the difference was statistically significant(P < 0.05).No anal incontinence was found in all patients after surgery.Conclusion: Laparoscopic total colectomy and lateral anastomosis of the small intestine and rectum is safe and feasible for the treatment of CSTC.Laparoscopic total colectomy can significantly improve the constipation symptoms and gastrointestinal quality of patients with CSTC.