[Changes of defecography pre- and post-Jinling procedure for mixed constipation: a prospective single center study].
OBJECTIVE
To evaluate the anatomy and functional changes of pelvis before and after Jinling procedure (subtotal colectomy and side-to-side colorectal anastomosis) using defecography.


METHODS
Fifty patients with refractory mixed constipation received Jinling procedure in the Jinling Hospital between March 2009 and December 2010 and were included in this prospective study. The defecography was performed at one week before surgery and 6 months after Jinling procedure. Longo outlet obstructed score, Wexner constipation score and Wexner incontinence score were also recorded before and after the procedure.


RESULTS
After 6 months follow-up, defecography showed that anterior rectocele, prolapse, intussusception, and descending perineum were significantly improved (P<0.01). Anterior rectoceles were significantly reduced in depth from 22.0±1.8 mm to 2.4±0.4 mm (P<0.01). Intussusception decreased from 1.9±0.4 cm to 0.4±0.5 cm (P<0.01). Compared with preoperative score, Longo score and Wexner constipation score were significantly improved from 17.6±3.8 to 5.3±2.0 and from 19.5±4.8 to 5.5±2.4, respectively (P<0.01).


CONCLUSIONS
Jinling procedure can correct the anatomy and functional pelvic disorders in mixed constipation. Clinical improvement of obstructed defecation syndrome after Jinling procedure correlates well with morphologic correction of the rectal redundancy.
Research Institute of General Surgery, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China.
Xiong-hui
XH
Hu
Jun
J
Jiang
Xiao-bo
XB
Feng
Wei-wei
WW
Ding
Wei-ming
WM
Zhu
Ning
N
Li
D000714:Anastomosis, Surgical; D003082:Colectomy; D003248:Constipation / Q000601:surgery*; D003672:Defecation; D019841:Defecography; D005260:Female; D006801:Humans; D011446:Prospective Studies; D020047:Rectocele; D016896:Treatment Outcome