Novel surgery for refractory mixed constipation: Jinling procedure - technical notes and early outcome

Area of Science:

• Colorectal Surgery
• Gastroenterology
• Surgical Innovation

Background:

• Treatment for slow-transit constipation with outlet obstruction remains controversial.
• A novel surgical strategy, the Jinling procedure, combining subtotal colectomy and a modified Duhamel procedure, was introduced.

Purpose of the Study:

• To evaluate the safety and efficacy of the Jinling procedure.
• To assess patient satisfaction rates following the surgical intervention.

Main Methods:

• Ninety patients with refractory slow-transit constipation and outlet obstruction were included.
• Laparoscopic-assisted Jinling procedure involved subtotal colectomy with a new side-to-side anastomosis.
• Pre- and post-operative data were collected for analysis.

Main Results:

• No surgery-related deaths occurred.
• A morbidity rate of 24.4% was observed, with most complications managed conservatively.
• A high satisfactory rate of 93.1% was reported at 6-month follow-up.

Conclusions:

• The Jinling procedure is a safe option for refractory slow-transit constipation with outlet obstruction.
• The technique requires meticulous surgical skill and perioperative care.
• Potential damage to the pelvic floor necessitates careful consideration of severe complications.