The proposed constipation scoring system correlated well with objective physiologic findings in constipated patients to allow uniformity in assessment of the severity of constipation.
In conclusion, laparoscopic resection of diverticulitis can be performed without additional morbidity particularly in Hinchey I patients and with a reduced length of hospitalization in patients with class I or II disease. Patients with class I disease, and after initial experience even those with class II disease, can benefit from the reduced morbidity and length of hospitalization associated with laparoscopic treatment.
The rapid improvement in these parameters may reflect both ascents in the learning curve and change in type of procedure. Adhesions, due to prior surgery or inflammation making dissection tedious, is the most important technical factor which effects operation time (p < 0.001). However, despite increased complexity, operating time decreased, reflecting improved skills. Thus, the experienced laparoscopic surgeon can increase the spectrum of applications with expectations of shorter operations and lower complication rates.
BTX-A is extremely successful for temporary treatment of anismus that is refractory to BF management. However, because the mechanism of action is short, longer term results are only 50 percent successful. Hopefully, modifications in the strain of BTX-A and dose administered will allow longer periods of success or a repeat trial of BF. Nonetheless, this preliminary report is very encouraging in offering a method of managing this recalcitrant condition.
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