Objective      To determine the clinical efficiency of laparoscopic colonic bypass with antiperistaltic cecoproctostomy in the treatment of elderly patients with slow transit const

ipation (STC)

and investigate its effect on the life quality and postoperative outcomes.       Methods        Clinical data of 26 elderly patients with age over 70 years old with intractable STC treated by laparoscopic colonic bypass with antiperistaltic cecoproctostomy in our institution from April 2007 to April 2010 were collected and retrospectively analyzed in this study. Intra-operative blood loss

operative time

first ventilation time

hospital stay

pre- and post-operative number of daily bowl movement (BM) at 3

6 and 12 months after the operation were analyzed. Wexner incontinence scale (WIS)

Wexner constipation scale (WCS)

Gastro-Intestinal Quality of Life Index (GIQLI)

abdominal pain scale (0-10 in numerical rating scale

NRS)

abdominal pain frequency and abdominal distension frequency scale

and Clavien-Dindo classification were adopted to evaluate the outcome and surgical complication (CD).       Results        The average age of 26 patients was 72.85±2.723

and most of them were female. Before the operation

all patients suffered from severe preoperative constipation

with a mean WCS score of 16.62±1.235

and very poor life of quality demonstrated by extremely low preoperative GIQLI score of 63.58±4.843. Laparoscopic surgeries were successfully carried out for all patients

with an average operative time of 41.85±3.728 min

the first bowel movements time of 3.92±1.917 d

and average hospital stay of 8.62±1.699 d. There was no case with anastomotic leakage or adhesive occlusion

and 3 cases had the surgical complications of CD>I

as pulmonary infection

and they were cured after the treatment operation. At the 3 th and 6 th months after the operation

no case presented serious diarrhea or fecal incontinence.After 6 months

the daily defecation reached 3.20±2.02198 times

and WIS was 2.50±1.944. WCS score

GIQLI index

frequency of abdominal pain and distension at the 3rd

6th and 12th month were much better than those before the operation (

P

<

0.01). No difference was found in NRS val

ue of abdominal pain intensity at the 3rd

6th and 12th month

and 7 patients showed NRS≥7

accounting for 26.92%.       Conclusion        Laparoscopic colonic bypass with antiperistaltic cecoproctostomy is an ideal approach for elderly STC patients

especially for those accompanied with cardiopumonary and cerebral diseases. In the operation

surgical indications should be strictly conducted to ensure curative effect.