Eight cases report of NOSES Jinling procedure in the treatment of refractory constipation

doi:10.3877/cma.j.issn.2095-3224.2019.04.014

Abstract

Abstract:

Objective

To evaluate the short-term efficacy of NOSES Jinling surgery in the treatment of intractable constipation.

Methods

Retrospective analysis of 8 surgical patients performed NOSES Jinling surgery in Jiangsu Subei People′s Hospital from July 2016 to May 2018. The general conditions and postoperative evaluation indexes were recorded.

Results

General conditions: mean operative time (265.63±36.09) min, intraoperative bleeding (40±15.81) mL. NOSES evaluation index: no deaths during perioperative period, first anal exhaust time (61.75±12.13) h, first time of bedtime (50.38±12.39) h, first feeding time (61.13±12.24) h, first defecation time (77.50±12.69) h, postoperative complications (1 case of abdominal infection).

Conclution

The short-term curative effect of NOSES Jinling surgery in the treatment of intractable constipation is affirmative, and the trauma is small, which can significantly reduce the psychological stress brought by the surgical incision, which is worth further promotion.

Key words: Constipation, NOSES, Jinling surgery, Intractable constipation

Jiaming Xu, Jie Wang, Jiawen Liu, Hanjian Zhu, Hongpeng Zhang, Zhuangzhuang Liu, Jin Gao, Wei Wang, Liuhua Wang, Dong Tang, Daorong Wang. Eight cases report of NOSES Jinling procedure in the treatment of refractory constipation[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2019, 08(04): 398-402.

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https://zhjzcjbdzzz.cma-cmc.com.cn/EN/Y2019/V08/I04/398

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References 23

[1]	Tack J, Müller-Lissner S, Stanghellini V, et al. Diagnosis and treatment of chronic constipation-a European perspective [J]. Neurogastroenterology & Motility the Official Journal of the European Gastrointestinal Motility Society, 2011, 23(8): 697-710.
[2]	Feng X, Su Y, Jiang J, et al. Changes in fecal and colonic mucosal microbiota of patients with refractory constipation after a subtotal colectomy [J]. Am Surg, 2015, 81(2): 196-204.
[3]	Kuscher S, Kronberger I, Oberwalder M, et al. Rare morphological disorder in therapy refractory chronic constipation [J]. International Journal of Colorectal Disease, 2015, 30(4): 579-580.
[4]	傅传刚，金黑鹰. 慢传输型便秘的术式选择[J]. 中国实用外科杂志, 2002, 22(12): 760-762.
[5]	李宁. 重视顽固性便秘规范化诊治[J]. 中国实用外科杂志, 2013, 33(11): 907-909.
[6]	姜军，冯啸波，丁威威, 等. 金陵术治疗混合型顽固性便秘的疗效与长期随访结果[J]. 中华胃肠外科杂志, 2011, 14(12): 925-929.
[7]	Jiang J, Chen Q, Feng X, et al. Therapeutic effect and long-term follow-up of the Jinling procedure for refractory constipation: a series of 1 100 cases [J]. Chinese Journal of Surgery, 2016, 54(1): 13-20.
[8]	汤东，蒋学通，高俊, 等. 腹腔镜金陵术对改善顽固性便秘患者焦虑抑郁状态疗效分析[J/CD]. 中华普外科手术学杂志(电子版), 2016, 10(2): 116-119.
[9]	王锡山. 关于结直肠功能外科与类NOTES技术的思考[J/CD]. 中华结直肠疾病电子杂志, 2014, 3(4): 231-233.
[10]	Emhoff IA, Lee GC, Sylla P. Transanal colorectal resection using natural orifice translumenal endoscopic surgery (NOTES) [J]. Digestive Endoscopy, 2014, 26(S1): 29-42.
[11]	Camilleri M. Inclusion criteria for pharmacodynamic and clinical trials in chronic idiopathic constipation: pitfalls in using Rome Ⅲ for functional constipation [J]. Therapeutic Advances in Gastroenterology, 2011, 4(3): 159-163.
[12]	Li N, Jiang J, Ding WW, et al. Novel surgery for refractory mixed constipation: analysis of the technical notes and outcome to Jinling procedure [J]. Chinese Journal of Surgery, 2012, 50(6): 509-513.
[13]	Ding W, Jiang J, Feng X, et al. Novel surgery for refractory mixed constipation: Jinling procedure-technical notes and early outcome [J]. Archives of Medical Science Ams, 2014, 10(6): 1129-1134.
[14]	李宁，姜军，丁威威, 等. 金陵术治疗顽固性混合型便秘的操作与效果分析[J]. 中华外科杂志, 2012, 50(6): 509-513.
[15]	Kamm MA, Hawley PR, Lennardjones JE. Outcome of colectomy for severe idiopathic constipation [J]. Gut, 1988, 29(7): 969-973.
[16]	Yalcin S, Yalcin B, Gecim EI. Surgical interventions in patients with chronic constipation refractory to intensive medical treatment [J]. Bratislavské Lekárske Listy, 2009, 110(1): 35-37.
[17]	Clayden GS, Adeyinka T, Kufeji D, et al. Surgical management of severe chronic constipation [J]. Archives of Disease in Childhood, 2010, 95(11): 859-860.
[18]	Aldulaymi BH, Rasmussen O, Christiansen J. Long-term results of subtotal colectomy for severe slow-transit constipation in patients with normal rectal function [J]. Colorectal Disease the Official Journal of the Association of Coloproctology of Great Britain & Ireland, 2001, 3(6): 392-395.
[19]	冯啸波，苏勇，姜军, 等. 顽固性便秘患者金陵术前后肠道菌群变化的研究[J/CD]. 中华普外科手术学杂志(电子版), 2012, 6(4): 403-409.
[20]	童卫东，刘宝华，张胜本, 等. 顽固性慢传输性便秘的外科治疗及病因研究[J]. Chin J Gastrointest Surg, 2002, 5(4): 266-268.
[21]	Ding W, Jiang J, Feng X, et al. Outcomes after surgery for refractory constipation patients complicated with megacolon [J]. Chin J Gastrointest Surg, 2014, 17(5): 453-456.
[22]	姜军，陈启仪，冯啸波, 等. 金陵术治疗顽固性便秘1 100例疗效分析[J]. 中华外科杂志, 2016, 54(1): 13-20.
[23]	汤东，王伟，王杰, 等. NOSES金陵术治疗顽固性便秘附二例报告[J/CD]. 中华结直肠疾病电子杂志, 2018, 7(1): 74-78.

患者	性别	年龄（岁）	BMI（kg/m²）	取标本途径	手术时间（min）	术中出血（mL）	预防性造口	胃肠生活质量评分
P1	女	51	22.49	经直肠	280	50	无	67
P2	女	19	19.63	经直肠	250	20	无	63
P3	男	71	25.95	经直肠	275	60	无	59
P4	女	68	20.7	经直肠	310	20	无	68
P5	女	66	23.88	经直肠	310	20	无	60
P6	女	47	19.45	经直肠	195	50	无	58
P7	女	43	24.44	经直肠	235	50	无	58

患者	性别	年龄（岁）	BMI（kg/m²）	取标本途径	手术时间（min）	术中出血（mL）	预防性造口	胃肠生活质量评分
P1	女	51	22.49	经直肠	280	50	无	67
P2	女	19	19.63	经直肠	250	20	无	63
P3	男	71	25.95	经直肠	275	60	无	59
P4	女	68	20.7	经直肠	310	20	无	68
P5	女	66	23.88	经直肠	310	20	无	60
P6	女	47	19.45	经直肠	195	50	无	58
P7	女	43	24.44	经直肠	235	50	无	58

患者	首次排气（h）	首次离床（h）	首次进食（h）	首次排便（h）	术后并发症	围手术期死亡
P1	48	50	56	71	无	无
P2	43	47	54	68	无	无
P3	62	39	53	79	无	无
P4	58	51	61	69	无	无
P5	68	44	51	73	无	无
P6	71	40	56	81	无	无
P7	60	51	67	70	无	无

患者	首次排气（h）	首次离床（h）	首次进食（h）	首次排便（h）	术后并发症	围手术期死亡
P1	48	50	56	71	无	无
P2	43	47	54	68	无	无
P3	62	39	53	79	无	无
P4	58	51	61	69	无	无
P5	68	44	51	73	无	无
P6	71	40	56	81	无	无
P7	60	51	67	70	无	无

项目	术前（8例）	术后（月）
项目	术前（8例）	1（8例）	3（7例）	6（5例）	12（2例）
GIQLI（分）	99.0±13.4	91.0±10.1	87.0±6.4	52.0±11.2	29.0±7.5
Wexner（分）	22.9±4.2	19.0±4.6	7.2±3.5	4.9±2.1	4.5±1.9
SCBM（次/d）	0.5±0.3	7.4±1.8	6.5±1.4	5.2±1.3	3.0±1.6

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