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Comparison of hand‐assisted laparoscopy with open total colectomy for slow transit constipation: A retrospective study
Author(s) -
Sheng Qin Song,
Lin Jian Jiang,
Chen Wen Bin,
Liu Fan Long,
Xu Xiang Ming,
Hua Han Ju,
Lin Cai Zhao,
Wang Jin Hai
Publication year - 2014
Publication title -
journal of digestive diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 51
eISSN - 1751-2980
pISSN - 1751-2972
DOI - 10.1111/1751-2980.12156
Subject(s) - medicine , colectomy , surgery , laparoscopy , constipation , retrospective cohort study , defecation , blood loss , total colectomy , ulcerative colitis , disease
Objective To compare the efficacy and safety of hand‐assisted laparoscopic colectomy ( HALC ) and open colectomy ( OC ) for patients with slow transit constipation ( STC ). Methods Data of patients with STC who underwent total colectomy from J anuary 2008 to D ecember 2012 were retrospectively reviewed after clinical evaluation and an exclusion of secondary causes. These patients were further divided into the HALC and OC groups. Patients' outcomes, including intraoperative and postoperative data on their recovery and complications were compared between the two groups. Results A total of 68 patients with STC were finally enrolled in the study, including 32 in the HALC group and 36 in the OC group. The baseline characteristics did not significantly differ between the two groups. Compared with the OC group, patients in the HALC group had a shorter length of incision, a longer operative time and less blood loss volume. There was no conversion to OC for patients undergoing HALC and no intraoperative complications in both groups. Furthermore, after operation, patients in HALC group experienced less pain (3.4 ± 0.7 vs 4.8 ± 1.0), earlier first passage of flatus (58.3 ± 6.3 h vs 73.4 ± 13.0 h), shorter length of postoperative hospital stay (8.8 ± 1.2 days vs 11.3 ± 1.7 days) but higher medical cost ( RMB 33 979 ± 3 135 vs RMB 29 828 ± 3 216). The overall postoperative complications and the satisfaction in defecation were comparable in the two groups. Conclusion HALC is a safe, minimally invasive and effective surgical alternative for treating STC , which is comparable to OC .