CAJ | 학술논문

目的：探讨腹腔镜下腹会阴联合手术（经腹直肠悬吊及盆底抬高、固定术联合经会阴吻合器直肠粘膜环切术或经肛门腔镜直线切割缝合器直肠前膨出修补术）对出口梗阻型便秘（OOC）的临床治疗效果。方法通过电话及门诊密集随访，回顾分析2012年5月至2013年5月我科12例 OCC 患者采用腹腔镜下腹会阴联合手术治疗的临床经验，并评估疗效。结果平均手术时间为110 min（80~140 min），平均术中出血量为30 ml（10~50 ml），无伤口感染，无吻合口瘘、吻合口出血及吻合口狭窄，无粘连性肠梗阻，无顽固性腹泻，无术后死亡。5例临床治愈，5例有显著疗效，2例无明显改善。结论腹腔镜下腹会阴联合手术治疗 OOC 效果明显，手术恢复快，无明显手术并发症发生。
목적：탐토복강경하복회음연합수술（경복직장현조급분저태고、고정술연합경회음문합기직장점막배절술혹경항문강경직선절할봉합기직장전팽출수보술）대출구경조형편비（OOC）적림상치료효과。방법통과전화급문진밀집수방，회고분석2012년5월지2013년5월아과12례 OCC 환자채용복강경하복회음연합수술치료적림상경험，병평고료효。결과평균수술시간위110 min（80~140 min），평균술중출혈량위30 ml（10~50 ml），무상구감염，무문합구루、문합구출혈급문합구협착，무점련성장경조，무완고성복사，무술후사망。5례림상치유，5례유현저료효，2례무명현개선。결론복강경하복회음연합수술치료 OOC 효과명현，수술회복쾌，무명현수술병발증발생。
Objective To discuss the efficacy of laparoscopic combined abdominal-perineal operation (laparoscopic rectal suspension and surgical elevation of pelvic floor combined with PPH or Bresler operation) in outlet obstructive constipation(OOC). Methods To summarize the treating experience of 12 OOC cases who had underwent laparoscopic combined abdominal-perineal operation between May. 2012 and May. 2013 in our department by outpatient and telephone follow-up and evaluate efficacy. Results Mean operation duration:110 min(80-140 min),mean intraoperative haemorrhage:30 ml(10-50 ml). No wound infection, anastomotic leakage,adhesive intestinal obstruction,intractable diarrhea or postoperative death was reported. Clinical cure was noticed in 5 cases,significant efficacy was noticed in 5 cases and no obvious improvement was noticed in 2 cases. Conclusion Laparoscopic combined abdominal-perineal operation has significant efficacy in treating OOC,which has a short recovery period,with no significant complications.