Objective To evaluate the efficacy and safety of natural orifice specimen extraction surgeries (NOSES)combined with Jinling surgery in treatment of intractable constipation.
Methods The data of patients with intractable constipation who received NOSES combined with Jinling surgery in North Jiangsu People′s Hospital were retrospectively collected. The Gastrointestinal Quality of Life Index (GIQLI), Wexner constipation score, times of spontaneous bowel movements (SCBM) every week, defecation satisfaction, incision cosmetic effect satisfaction, Anxiety Self-Rating Scale (SAS) and Depression Self-Rating Scale (SDS) were used to evaluate the effect of surgery.
Results There were no perioperative deaths. The preoperative GIQLI score was (53.0±5.1), and the GIQLI score three month after surgery was higher than that before surgery, and the score continued to increase afterwards, showing statistically significant differences (P < 0.05). The Wexner constipation score was (13.1±2.5), (11.1±2.4), (8.1±2.0), and (5.9±1.4) at one month, three months, six months, and 12 months after operation, which showed statistically significant differences compared with (23.8±3.5) of preoperative Wexner constipation score (P < 0.05). The patients′ SCBM gradually decreased with the prolongation of postoperative time, maintained at (4.8±1.1) times per day six months, and maintained at (4.1±0.9) times per day after 12 months. As the patient′s defecation frequency became normal, and the defecation satisfaction and incision cosmetic effect were better, the patient′s anxiety and depression symptoms gradually improved, and the SAS and SDS scores decreased significantly 6 to 12 months after the operation compared with treatment before(P < 0.05).
Conclusion NOSES combined with Jinling surgery can not only improve the somatic symptoms of patients with intractable constipation, but also solve the psychological barriers of patients.
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