[Surgical innovation for refractory constipation (Jinling procedure): a long-term follow-up of its safety and efficacy].
OBJECTIVE
To propose a novel surgical procedure for refractory constipation, namely Jinling procedure, and to explore its safety and efficacy through long-term follow-up.


METHODS
A total of 614 patients with refractory constipation were admitted to the Department of General Surgery between February 2000 and June 2011. Five hundred and fifty-four patients received Jinling procedure and were included in this study. The general clinical data, complications after Jinling procedure, gastrointestinal quality of life index (GIQLI), Wexner constipation scale and satisfaction rate during follow-up were collected.


RESULTS
No operation-associated death occurred. Increased bowel movement frequency was observed during the perioperative period. Temporary difficulty in urination occurred in 24.5% of the patients. Other complications included small bowel obstruction (9.6%), anastomotic bleeding (8.1%), anastomotic leakage (3.1%), sexual dysfunction (3.1%), and wound infection (3.1%). Most postoperative complications were managed conservatively. The most recent follow-up was on August 2011, and the follow-up rate was 100%, 88.8%, 75.1%, 56.3% at 3, 6, 12, and 24 months after surgery. GIQLI temporarily increased from 78.1±9.4 preoperatively to 92.0±9.5 at 3 months follow-up, but continued to decrease during the follow-up at the 6 months (48.4±14.1), 12 months (21.0±4.3), and 24 months (20.0±3.4). Wexner constipation scale decreased from 19.9±4.3 preoperatively to 8.4±2.1 at 3 months follow-up (P<0.01). The low Wexner scale sustained until 24 months after operation. The satisfaction rate at the 3, 6,12 and 24 months follow-up was 78.1%, 91.1%, 94.2% and 94.6%, respectively.


CONCLUSIONS
Jinling procedure provides refractory constipation patients with a novel, safe and effective surgical option.
Research Institute of General Surgery, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China.
Jun
J
Jiang
Xiao-bo
XB
Feng
Wei-wei
WW
Ding
Jian-lei
JL
Liu
Xiong-hui
XH
Hu
Ning
N
Li
Jie-shou
JS
Li
D003248:Constipation / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007415:Intestinal Obstruction / Q000601:surgery; D011788:Quality of Life; D016896:Treatment Outcome