Clinical efficacy of laparoscopic subtotal colectomy in adult megacolon

Abstract

ObjectiveTo observe the clinical efficacy and safety of laparoscopic subtotal colectomy + loop colostomy in adult patients with megacolon. MethodsRetrospective analysis was performed on the clinical data of 22 adult megacolon patients treated by laparoscopic subtotal colectomy + loop colostomy in Affiliated Hospital of Nanjing University of Chinese Medicine from October 2016 to October 2020. All patients underwent preoperative CT, barium enema, anorectal manometry, and postoperative pathological examination to diagnose megacolon. The symptoms of abdominal pain and abdominal distension, gastrointestinal quality of life score index（GIQLI）, Wexner constipation score and surgical complications were analyzed and compared before and after surgery. ResultsThe incidence of preoperative abdominal distension symptoms of 22 patients was 100%, and all improved after surgery. The incidence of abdominal distension at 12 months after surgery was 4.5% （1/22）. The Wexner constipation scores at the 6th and 12th months after surgery were 6.27±2.16 and 4.77±1.11, respectively, significantly better than the preoperative score （20.41±2.48, P＜0.05）. The GIQLI at the 6th and 12th months after surgery were 104.05±12.09 and 102.23±8.20, respectively, significantly better than the preoperative score （68.64±6.04, P＜0.05）. The postoperative complications included 1 infection at the operation site （4.5%）, 1 case of anastomotic fistula （4.5%）, 1 case of abdominal bleeding （4.5%）. ConclusionLaparoscopic subtotal colectomy + loop colostomy is a safe and effective operation for the treatment of adult megacolon, which is worthy of further exploration and application.

Keywords

• megacolon
• laparoscopic
• subtotal colectomy
• terminal ileal loop type ostomy
• abdominal distension
• loop colostomy