Clinical outcome between Jinling procedure and total colectomy with ileorectal side-to-side anastomosis for refractory mixed constipation: A prospective controlled trial        FENG Xiao-bo，JIANG Jun，DING Wei-wei，et al. Research Institute of General Surgery，Nanjing General Hospital of Nanjing Military Command，Affiliated Jinling Hospital of Nanjing University School of Medicine, Nanjing 210002，China
Corresponding  author：JIANG Jun，E-mail：jiangjun6987@163.com
Abstract    Objective    To compare the morbidity and efficacy between Jinling procedure and total colectomy with ileorectal side-to-side anastomosis in the treatment of refractory mixed constipation. Methods    A total of 156 cases of refractory mixed constipation admitted between February 2009 and December 2010 in Nanjing General Hospital of Nanjing Military Command were analyzed. Group A was performed Jinling procedure. Group B was performed laparoscopic assisted total colectomy with ileorectal side-to-side anastomosis. Results    Primary outcomes included operation time, first flatus time, Wexner constipation score, gastrointestinal quality of life index (GIQLI), stool frequency, incidence of diarrhea, diarrhea severity, satisfaction, contentment, serum electrolyte level and surgical complications were observed after operation 1 months, 3 months, 6 months, 12 months until 24 months. Postoperative Wexner constipation score and GIQLI both in two Groups were improved significantly compared with preoperative data (P<0.05). Postoperative stool frequency，incidence of diarrhea，contentment，Wexner constipation score，GIQLI and progress of recovery of Group A were superior to Group B (P<0.05). There was no significant difference in postoperative surgical complication between 2 groups (P＞0.05). The incidence of adhesive ileus in Group B was higher than Group A significantly. Conclusion    Jinling procedure is superior to total colectomy with ileorectal side-to-side anastomosis in clinical outcome for refractory mixed constipation. Patients can get better quality of life and satisfaction besides relieving the constipation.