title: [Study of subtotal colectomy combined with psychological intervention in treating slow transit constipation].
abstract: OBJECTIVE
  To investigate the value of psychological intervention in treating slow transit constipation (STC), and to provide the reference to clinical treatment for STC patients with psychological disorder.
  
  
  METHODS
  A total of 94 STC patients with psychological disorder admitted to the Anorectal Hospital of Chengdu from June 2010 to August 2012 were prospectively enrolled and divided into psychological intervention group(subtotal colectomy plus postoperative psychological intervention) and control group (subtotal colectomy without postoperative psychological intervention). Scores of Hamilton depression scale (HAMD), Hamilton anxiety scale(HAMA), Wexner constipation scale (WCS) and gastrointestinal quality-of-life index(GIQLI) were recorded 1, 3, 6, 12 and 24 months after operation. SPSS 17.0 statistical software was used to analyze the data.
  
  
  RESULTS
  There were no differences in baseline data, operative time, blood loss, time to the first flatus and time to the first defecation between two groups(all P>0.05). The scores of HAMD and HAMA were significantly reduced in psychological intervention group compared with control group 3, 6, 12 and 24 months after operation (all P<0.05). Ratios of cure, obvious progress, progress and invalidation of depression symptoms in psychological intervention group were 2.6%(1/39), 66.7%(26/39), 25.6%(10/39) and 5.1% (2/39) respectively at postoperative 24-month, which were better than those [0, 34.2%(13/38), 44.7% (17/38) and 21.1%(8/38) respectively] in control group with significant difference(P=0.013). Ratios of cure, obvious progress, progress and invalidation of anxiety symptoms in psychological intervention group were 10.3%(4/39), 53.8%(21/39), 28.2%(11/39) and 7.7%(3/39) respectively at postoperative 24-month, which were better than those [0, 28.9%(11/38), 55.3%(21/38) and 15.8%(6/38) respectively] in control group with significant difference (P=0.011). The WCS scores in psychological intervention group were lower than those in control group 6, 12, 24 months after operation (all P<0.05). The GIQLI scores in psychological intervention group were higher than those in control group 3, 6, 12 and 24 months after operation(all P<0.05).
  
  
  CONCLUSIONS
  Subtotal colectomy combined with psychological intervention not only can significantly improve psychological disorder, but also increase the efficacy of surgery in the treatment of slow transit constipation patients with psychological disorder.
authors.affiliation: Department of Constipation, Sichuan Intercontinental Gastrointestinal-disease Hospital / Chengdu Anorectal Hospital caojin-branch, Chengdu 610045, China.
authors.forename: Wenjing
authors.initials: W
authors.lastname: Gong
authors.affiliation: Department of Constipation, Sichuan Intercontinental Gastrointestinal-disease Hospital / Chengdu Anorectal Hospital caojin-branch, Chengdu 610045, China.
authors.forename: Xizhong
authors.initials: X
authors.lastname: Zhao
authors.affiliation: Department of Constipation, Sichuan Intercontinental Gastrointestinal-disease Hospital / Chengdu Anorectal Hospital caojin-branch, Chengdu 610045, China.
authors.forename: Meizhu
authors.initials: M
authors.lastname: Zhao
authors.affiliation: Department of Constipation, Sichuan Intercontinental Gastrointestinal-disease Hospital / Chengdu Anorectal Hospital caojin-branch, Chengdu 610045, China.
authors.forename: Haibo
authors.initials: H
authors.lastname: Lan
authors.affiliation: Department of Constipation, Sichuan Intercontinental Gastrointestinal-disease Hospital / Chengdu Anorectal Hospital caojin-branch, Chengdu 610045, China.
authors.forename: Hui
authors.initials: H
authors.lastname: An
authors.affiliation: Department of Constipation, Chengdu Anorectal Hospital, Chengdu 610015, China. y-xd@vip.163.com.
authors.forename: Xiangdong
authors.initials: X
authors.lastname: Yang
mesh_terms: D003082:Colectomy; D003248:Constipation; D003672:Defecation; D005772:Gastrointestinal Transit; D006801:Humans; D061646:Operative Time; D011184:Postoperative Period; D011788:Quality of Life; D016896:Treatment Outcome