title: [Influence of length of preserved ileocecum on the efficacy of laparoscopic subtotal colectomy antiperistaltic cecorectal anastomosis in the treatment of slow transit constipation].
abstract: OBJECTIVE
  To investigate the influence of length of preserved ileocecum on the efficacy of laparoscopic subtotal colectomy antiperistaltic cecorectal anastomosis (LSCACRA) in treating slow transit constipation (STC).
  
  
  METHODS
  Clinical data of 81 STC patients who received LSCACRA between April 2007 And December 2011 in the 150th Center Hospital of PLA were continuously collected. Patients were divided into two groups: 10 cm to 15 cm ascending colon preserved above ileocecal junction(10-15 cm group, n=41), and 2 cm to 3 cm ascending colon preserved above ileocecal junction (2-3 cm group, n=40). The Wexner constipation scale (WCS), Wexner incontinence scale(WIS), gastrointestinal quality of life index(GIQLI), abdominal pain intensity scale(NRS), abdominal pain frequency scale and abdominal bloating frequency scale in the two groups were determined and compared before and 6, 12, 24 months after operation.
  
  
  RESULTS
  No postoperative incontinence was found in all the patients. There were no significant differences in evacuation frequency between two groups at 6th and 12th month after surgery (all P>0.05). Two years after operation, barium enema emptying time examination revealed 2-3 cm group was (17.7±9.5) h, which was remarkably shorter than (21.2±20.7) h in 10-15 cm group (P=0.011). The WCS, GIQLI, NRS and abdominal pain frequency scale of two groups were improved obviously at 6th, 12th and 24th month after surgery (all P<0.01). Above parameters in 2-3 cm group were superior to 10-15 cm group (all P<0.01), but abdominal bloating frequency scale was not significantly different between the two groups (P>0.05). As compared with before operation, NRS in 2-3 cm group 6, 12, 24 months after operation reduced remarkably (all P<0.01), but did not improve obviously in 10-15 cm group (P>0.05).
  
  
  CONCLUSIONS
  The shorter length of ascending colon preserved above ileocecal junction can improve the efficacy of LSCACRA in the treatment of STC and the prognosis of patients. Two to three cm length of ascending colon preserved above the ileocecal junction should be recommended.
authors.affiliation: Department of Anus-Colorectal Surgery, The 150th Central Hospital of Chinese People's Liberation Army, Luoyang 471031, China. wd150yyw5k@yeah.net.
authors.forename: Dong
authors.initials: D
authors.lastname: Wei
authors.forename: Jian
authors.initials: J
authors.lastname: Cai
authors.forename: Ting
authors.initials: T
authors.lastname: Zhao
authors.forename: Hui
authors.initials: H
authors.lastname: Zhang
authors.forename: Yuanyao
authors.initials: Y
authors.lastname: Zhang
authors.forename: Jianfeng
authors.initials: J
authors.lastname: Zhang
authors.forename: Yongli
authors.initials: Y
authors.lastname: Cao
mesh_terms: D015746:Abdominal Pain; D000714:Anastomosis, Surgical; D000930:Antidiarrheals; D002432:Cecum; D003082:Colectomy; D003248:Constipation; D004733:Enema; D006801:Humans; D007082:Ileum; D010535:Laparoscopy; D011184:Postoperative Period; D011379:Prognosis; D011788:Quality of Life; D012007:Rectum; D016896:Treatment Outcome
chemical_list: D000930:Antidiarrheals