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[Diagnosis and surgical treatment of idiopathic slow transit constipation]
1Department of Coloanorectal Surgery, Changhai Hospital, Sencond Military Medical Unerversity, People's Liberation Army, Shanghai 200433.
Objective:
To investigate the pathogenesis, the diagnostic criteria, and the therapeutic method of idiopathic slow transit constipation.
Methods:
History recording, bowel transit, anorectal dynamic, electromyography of the pelvic floor and defecography were performed before subtotal or total colectomy for severe constipation resistant to conservative treatment.
Results:
The natural stool frequency was decreased and the time of bowel transit was delayed. The rectal sensation and the ability to reflect inhibition of the pelvic floor when attempting to defecate were damaged significantly compared with normal controls. pathological findings showed that the argyrophilic neurons in the myentenic and submucous plexus reduced quantitatively. All the patients were followed up for an average of 32.2 months. Satisfactory functional outcome was obtained in 91.8% of the patients receiving the operation.
Conclusions:
The severe damage colon transit function is due to the impairement of the myentenic and submucous plexus of the colon. It causes vary. The diagnosis of the disease is dependent on the typical clinic features and the bowel transit test. The symptoms of constipation could be relieved effectively by removal of the pathologic colon.