Colon transit time of patients with chronic constipation and clinical significance / 第三军医大学学报

Objective To detect the total colon transit time (CTT) and segmental CTT of patients with chronic constipation and explore the clinical significance. Methods Colon transit study and defecography(DFG) were performed on 60 patients with chronic constipation. These patients were divided into 3 groups: group Ⅰ, 19 patients with slow transit constipation based on low stool frequency and normal DFG, group Ⅱ, 22 patients with rectal intussusception diagnosed by DFG and group Ⅲ, 19 patients with external rectal prolapse or puborectal muscle syndrome based on the results of DFG. Results Group Ⅰ showed increased total CTT (mean, 96.2 h) and segmental CTT, right colon, 35.3 h (36.7%), left colon, 30.8 h (32.0%), rectosigmoid, 30.1 h (31.3%). Group Ⅱ had normal mean total CTT (57.8 h) and a relative decrease in rectosigmoid CTT [mean, 13.8 h (23.9%)]. In group Ⅲ, patients showed elevated total CTT(mean, 175.1 h) and rectosigmoidal CTT [mean, 115.8 h(66.1%)]. There were significant differences in mean total CTT and rectosigmoidal CTT among the 3 groups ( P

A combination of pelvicography and colpocystodefecography and defecography for the diagnosis of outlet obstructive constipation / 中国普通外科杂志

Objective To study the morphologic and structural changes of the pelvic floor and corresponding visceras in patients with outlet obstructive constipation (OOC). Methods We used simultaneous pelvicography and colpocystodefecography (PCCD), including pelvicography, vaginal opacification, voiding cystography and defecography in 38 patients with OCC and 12 healthy volunteers. Anorectal angle, the level of perineum, and bladder were measured. Results Internal rectal prolapse (IRP) in 37 cases, rectocele (RC) in 5 cases and spastic pelvic floor syndrome (SPFS) in 5 cases were diagnosed by PCCD. While common physical examination alone detected only 12 cases, 4 RC cases and one SPFS case, which were confirmed by PCCD. Moreover, PCCD found 9 cases of pelvic floor hernia or peritoneoceles, 6 cases of cystoceles, 3 cases of descending perineum syndromes, and 10 cases of uterine prolapses. Compared with controls, OOC patients had a larger anorectal angle during defecation, abnormal descending of perineum at rest and defecation, and a deep pouch of Douglas during defecation. Some patients with urinary system symptoms have an abnormal descent of bladder during rest and defecation. Conclusion PCCD has a higher detection rate than common physical examination in diagnosing IRP and RC, and provides information for diagnosis of pelvic floor hernia or peritoneocele, cystocele or uterine prolapse. PCCD helps in the selection of a proper surgical procedure for OOC patients.

Surgical treatment for internal rectal prolapse / 中国普通外科杂志

Objective To evaluate operative effect on internal rectal prolapse. Methods Sixty-two patients with internal rectal prolapse who underwent operation were studied by retrospectively analyzing the treatment and followed up results. Results The total success rate of surgical treatment for internal rectal prolapse is 73%. The rate of symptoms improvement as difficulty in defecation,anal aboating, incomplete defecation,asistation with fingers,and defecating dependent on laxatives were 77%,80%,71%,86%,97% respectively. Conclusion the operative indications of internal rectal prolapse should be strictly controlled. Only those who received standard conservative treatment and failed to improve should be a candidate for surgery.