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《Chinese Journal of Gastrointestinal Surgery》 2002-04
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Surgical treatment for refractory slow transit constipation and its etiology

TONG Weidong, LIU Baohua,ZHANG Shengben,et al. Department of General Surgery,Research Institute of Field Surgery,Daping Hospital,The Third Military Medical University,Chongqing 400042,China  
Objective To evaluate the outcome of colectomy for refractory slow transit constipation (STC) and study the changes of colonic nervous transferring substances. Methods Clinicopathologic data including colon transit, defecography, colonscope, sex hormones. Of 34 patients with refractory STC, which underwent colectomy during recent ten years, were studied, Vasoactive intestinal peptide(VIP) and NO synthetase were examined by immunohistochemistry. All patients were followed up. Results Colonic transit time ranged from 96 to 240 hours, with a mean time of 136 hours. 85 3% (29/34) of patients were accompanied with obstructive outlet constipation (OOC). 61 8% (21/34) showed abnormal sex hormones. Most patients were satisfied with the results of their operation, except one case with recurrence. Moreover, a higher NOS and lower VIP positive neuron density were found at the colonic myenteric plexus. Conclusions Colectomy possesses a satisfactory functional outcome for the patients with refractory slow transit constipation, failing in comprehensive internal treatment. OOC should be treated simultaneously. The changes of VIP and NOS may be one of the causes of STC.
【CateGory Index】: R657.1
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