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만성 변비 환자에서의 대장 아전절제술의 임상적 결과

Clinical Results of Subtotal Colectomy in Chronic Constipation Patients

대한대장항문학회지 2000년 16권 6호 p.395 ~ 401
남기현 ( Nam Kee-Hyun ) - 연세대학교 의과대학 외과학교실

손승국 ( Sohn Seung-Kook ) - 연세대학교 의과대학 외과학교실

Abstract


Purpose: The aim of this study was to assess the outcome of subtotal colectomy on patients with a diagnosis of chronic constipation.

Methods: A retrospective review of 11 consecutive patients who underwent subtotal colectomy between January 1990 and July 1999 was undertaken. Preoperative testings included complete history and physical examination, anorectal manometry, videodefecography, and colonic transit studies.

Results: The 11 patients consisted of 5 men and 6 women, with a mean age of 44 (range, 25∼62) years.The most common symptom was inability to defecation and mean duration of this symptom was 13.6 (range, 0.75∼45) years. Ten patients had slow colon transit and one patient had normal colon transit with anismus. All patients were followed up for mean duration of 33 (range, 5∼120) months. Mean bowel frequency was 4 times per day after colectomy. Nine patients were satisfied with the results of surgery and showed improvement in quality of life. One patient was less satisfied due to diarrhea even with several times bowel movement per day. One patient felt that the operation was not so effective due to incontinence for liquid stool and 7 bowel movement per day. Three patients frequently used antidiarrheal medication after surgery. Three patients had postoperative small bowel obstruction and were treated without surgery.

Conclusion: Subtotal colectomy with ileorectal anastomosis produces a satisfactory functional outcome in the majority of patients with proven slow transit constipation.

키워드

대장 아전절제술;변비;지연성 대장 통과 변비;치골직장근 불이완증;임상적 결과
Subtotal colectomy;Constipation;Slow transit constipation;Anismus;Clinical results
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