[Evaluation of surgical outcomes using imaging study for patients with slow transit constipation complicated with outlet obstruction].
OBJECTIVE
To explore the clinical significance of multiple radiography of the pelvis in the evaluation of surgical outcomes for patients with slow transit constipation complicated with outlet obstruction.


METHODS
Patients with slow transit constipation complicated with outlet obstruction were diagnosed by multiple radiography of the pelvis after screening using colon transit study. Surgery was performed according to the cause of the obstruction. Anorectal angle and the locations of perineum, pelvic peritoneum, and bladder were assessed by multiple radiography of the pelvis one month after surgery. The changes in locations of pelvic organs were assessed and the imaging appearance after the release of obstruction was observed.


RESULTS
A total of 48 patients were included. Rectocele repair, partial mucosectomy with rectopexy, and hysteropexy were performed. All the patients were followed up with a mean length of 19(6-58) months. Excluding 2 patients who had no symptomatic improvement, the mean bowel movements was 1.9 times per day in the remaining 46 patients(95.8%). Preoperative anorectal angle at the squeezing phase was(128.09±13.82) degree and the difference between squeezing and resting phase was (11.14±12.58) degree, while the postoperative angle was (180.26±9.98) degree and the difference(20.01±13.11) degree(P<0.05). Preoperative location of the perineum at the squeezing phase was(-2.05±0.83) cm and the difference was(2.23±0.78) cm, while postoperative location was (-0.50±1.13) cm and the difference was (2.18±1.04) cm(P<0.05). Preoperative location of the pelvic peritoneum at the squeezing phase was(4.91±1.32) cm and the difference was (1.32±0.89) cm, while postoperative location was (2.62±2.53) cm and the difference was (3.28±0.68) cm (P<0.05). Preoperative bladder location at the squeezing phase in patients with urological symptoms was (3.92±2.51) cm and the difference was(1.39±1.27) cm, while postoperative location was (2.15±1.55) cm and the difference was (1.98±1.54) cm(P<0.05).


CONCLUSIONS
Multiple imaging of the pelvis provides objective evidence in the evaluation of surgical outcomes for patients with chronic slow transit constipation complicated with outlet obstruction.
Liu
Xiang-dong
XD
Department of Radiology, The Third Hospital, Hebei Medical University, Shijiazhuang 050051, China. liuxiangdong2004@yahoo.com.cn
Zhang
Wei
W
Yu
Bao-hai
BH
Zhao
Jia-ning
JN
Chai
Bin
B
Fan
Xin-yun
XY
Zhao
Shi-peng
SP
Zhao
Fa
F
D000328:Adult; D000368:Aged; D003248:Constipation / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D003938:Diagnostic Techniques, Digestive System; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D055815:Young Adult