腹腔鏡乙狀結腸切除術治療慢性便秘併乙狀結腸過長的病患

Laparoscopic sigmoidectomy in patients with chronic constipation and redundant sigmoid colon

方佳偉(Chia-Wei Fang)

指導教授 ： 曾淑玲

中山醫學大學/醫學院/醫學研究所/碩士(2014年)

摘要

這篇文章主要是評估用腹腔鏡乙狀結腸切除術治療慢性便秘併乙狀結腸過長的病患。從2013年一月到2013年十二月，我們收集了12個因慢性便秘併乙狀結腸過長的病患，他們都接受腹腔鏡乙狀結腸切除術治療。我們統計了他們術前及術後三個月的Wexner’s便秘評估表，並分析其分數變化以評估手術的預後。當然我們也統計了病患得術後滿意度。這12位病患全為女性，平均年齡是43歲 (從33歲到68歲)。術前的Wexner’s便秘評估表平均分數是18.2 (從13到23)，術後三個月的Wexner’s便秘評估表平均分數是9.8 (從0到16)。沒有發生術中或術後的死亡病例，也沒有術後早期的併發症，只有一位病患發生術後晚期的腸阻塞，此病患經非手術治療就康復了。12位病患中有10位病患對其手術成果感到非常滿意。針對特定乙狀結腸切除術治療慢性便秘併乙狀結腸過長的病患，腹腔鏡乙狀結腸切除術提供了一個低併發症的手術方式來治療這些病患。然而我們還必須長期追蹤下去，以評估這些病患是否有持續性的改善。

關鍵字

慢性便秘 ； 腹腔鏡結腸切除術

並列摘要

Purpose:
The aim of this study was to evaluate the result of laparoscopic sigmoidectomy in patients with chronic constipation and redundant sigmoid colon.

Methods:
Between January 2013 and November 2013, we retrospectively investigated 12 patient with chronic constipation and redundant sigmoid colon who underwent
a laparoscopic sigmoidectomy. Preoperative and postoperative( 3 months later) Wexner’s constipation scores were collected and used to evaluate the outcomes after surgical treatment. We also collected patients’ postoperative satisfaction scores.

Results:
The 12 patients were women with a median age of 43 years (range, 33 to 68 years). Pre- and post-operative Wexner’s scores were collected from 12 patients, and the mean preoperative Wexner’s score was 18.2 (range, 13 to 23), which decreased to an average post-operative score of 9.8 (range, 0 to 16). Neither intraoperative compli- cations nor postoperative mortalities were noted. No patients had early postoperative complications, but only one patient had late postoperative ileus which was managed with non-operative treatment. Ten of 12 patients were satisfied with their surgical out- come (83%).

Conclusion:
For selected patients, laparoscopic sigmoidectomy might be an effective surgical procedure with lower morbidity in patients with chronic constipation and redundant sigmoid colon. However, long-term follow-up examinations are required to show if there is persisted improvement in Wexner’s score and patients’ postoperative satisfaction scores.

並列關鍵字

chronic constipation ； laparoscopic colectomy

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