Outcome of segmental colonic resection for slow-transit constipation

Lundin, Erik; Karlbom, Urban; Påhlman, Lars; Graf, Wilhelm

doi:10.1046/j.1365-2168.2002.02213.x

Cited by 79 publications

(60 citation statements)

References 19 publications

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“…In our study we report only one small-bowel obstruction but this occurred in a patient who had a laparotomy postoperatively, therefore eliminating the theoretical benefits of laparoscopic surgery. The best results that have been published are with total abdominal colectomy, nonetheless there are reports in the literature showing studies with segmentary resection of the colon [18,19], but they have had previous evaluation of colonic transit time with scintigraphic markers to ensure that the transit is slow in only the segment that is resected. In short-term follow-up the results are acceptable, however, in long-term follow-up the results are only regular [20].…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic total colectomy for colonic inertia: surgical and functional results

et al. 2008

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Section: Discussionmentioning

confidence: 99%

Laparoscopic total colectomy for colonic inertia: surgical and functional results

et al. 2008

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“…In the present study, we have shown that the success rate of STC-CRA in CI achieved 79% at a mean follow-up of 10.5 yr after surgery. When compared to previous studies that investigated STC-IA for CI [6][7][8]15,17,18,[20][21][22][23][24][25][26][27][28] , the slightly lower rate of success (79% vs 88% to 100%) recorded in the present study must be tempered by the longer follow-up (10.5 yr vs 1 to 8.9 yr), the absence of postoperative complications related to the laparoscopic technique, the low postoperative morbidity, and the absence of recurrent disabling constipation. Indeed, the mean number of bowel motions was significantly increased in all patients after surgery, being disabling in only one, and none complained during the follow-up of what they called constipation.…”

Section: Discussionmentioning

confidence: 99%

“…With the introduction of methods that enable the evaluation of pelvic floor dysfunction, it has become of crucial importance to divide patients with severe constipation into those with CI and those with a predominant altered pelvic floor function. Indeed, there is growing acceptance that the presence of outlet obstruction [14] , alterations in rectal sensitivity [15] or megarectum [16] associated with slow transit constipation are predictive of a low rate of success of surgical treatment. Knowles et al [12] have observed higher functional results of STC-IA when CTT, anorectal manometry and cinedefaecography were systematically performed.…”

Section: Discussionmentioning

confidence: 99%

Long-term results of subtotal colectomy with cecorectal anastomosis for isolated colonic inertia

Iannelli

Piche²,

Dainese³

et al. 2007

WJG

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AIM:To evaluate the results of sub total colectomy with cecorectal anastomosis (STC-CRA) for isolated colonic inertia (CI). METHODS:Fourteen patients (mean age 57.5 ± 16.5 year) underwent surgery for isolated CI between January 1986 and December 2002. The mean frequency of bowel motions with the aid of laxatives was 1.2 ± 0.6 per week. All subjects underwent colonoscopy, anorectal manometry, cinedefaecography and colonic transit time (CTT). CI was defined as diffuse markers delay on CTT without evidence of pelvic floor dysfunction. All patients underwent STC-CRA. Long-term follow-up was obtained prospectively by clinical visits between October 2005 and February 2006 at a mean of 10.5 ± 3.6 years (range 5-16 years) during which we considered the number of stool emissions, the presence of abdominal pain or digitations, the use of pain killers, laxatives and/or fibers. Patients were also asked if they were satisfied with the surgery. RESULTS:There was no postoperative mortality. Postoperative complications occurred in 21.4% (3/14). At the end of follow-up, bowel frequency was significantly (P < 0.05) increased to a mean of 4.8 ± 7.5 per day (range 1-30). One patient reported disabling diarrhea. Two patients used laxatives less than three times per month without complaining of what they called constipation. Overall, 78.5% of patients would have chosen surgery again if necessary. CONCLUSION:

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“…They only resected some segmental long-winded colon. Hemicolectomy could lead to fewer postoperative complications and a faster recovery [6] , but the postoperative recurrence rate was very high [7] . This is because the excisional range of the pathological colon is not large enough.…”

Section: Characteristics and Clinical Application Perspectives Of Colmentioning

confidence: 99%

Colonic exclusion and combined therapy for refractory constipation

Peng

Xu²

2006

WJG

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INTRODUCTIONRefractory constipation is a common clinical symptom. Because it is very obstinate and its etiological factors are unclear, it is difficult for medical workers to treat the patients. The problem of difficult defecation usually cannot be solved with drug treatment. According to our experience, surgical treatment is suggested for the patients who are unresponsive to cathartics or who need to ingest exceeding cathartics to evacuate their bowels. There are many conventional surgical methods, such as total colectomy, subtotal colectomy, hemicolectomy, etc. However, the operation time of these surgical methods is too long. Besides, these surgical methods with big trauma will give rise to many postoperative complications and negatively affect the quality of the patients' lives. Moreover, the very aged patients cannot bear these operations and their treatment is far from satisfactory [1] . Since 1998 we have adopted colonic exclusion with colorectal anastomosis and treated 14 patients of refractory constipation. All of them were satisfied with the therapeutic effects. The quality of patients' lives had been improved significantly after operations. Our clinical practice demonstrates that colonic exclusion is a safe and feasible operation. It has good therapeutic effects, shorter surgical time, and lower complication incidences. MATERIALS AND METHODS General dataT hir ty-two patients were diagnosed as refractor y constipation between January 1998 and April 2006. These patients received surgical intervention after ineffective medical treatment. They were divided into two groups randomly. There were two males and twelve females in treatment group (n = 14). Their ages ranged from 31 to 77 years with a mean age of 45. Their courses of disease ranged from three to thirty years with 12 years on average. Among them, ten patients had rectocele, and eight patients had rectal prolapse. Five males and thirteen females entered control group (n = 18). Their ages ranged from 28 to 75 years with a mean age of 51. Abstract AIM: To inve��ig��e �he �he��eu�i�� e��e��ivene�� o� ��o�oni�� e��u�ion �n�� o��ine�� he�� o� �e��o�� on��i��ion. METHODS:T h i � ��-� w o � � � i e n � � w i � h � e �� o � �� on��i��ion we�e ��n��o�� ivi��e�� in�o ��e��en� g�ou� (n = 14) �n�� on��o� g�ou� (n = 18). Fou��een ��ien�� in ��e��en� g�ou� un��e�wen� ��o�oni�� e��u�ion �n�� en��-�o-�i��e ��o�o�e�� n��o�o�i�. Eigh�een ��ien�� in ��on��o� g�ou� �e��eive�� u��o�� o�e��o�� n�� en��-�o-en�� o�o�e�� n��o�o�i�. The �he��eu�i�� e��e�� o� �he o�e��ion� we�e ��e��e�� o��ing �he �u�gi�� i�e, in��i�ion �eng�h, vo�u�e o� ��oo�� o��e�, ho��i�� , �e��ove�� e �n�� o��i��ion in��i��en��e. A�� ien�� e��eive�� ong-�e�� o��ow-u�. CONCLUSION: �o�oni�� e��u�ion h�� e��e� �he��eu�i�� e��i�� on �e��o�� on��i��ion. I� h�� n�� v�n��ge� �u��h �� ho��e� �u�gi�� i�e, ��e� in��i�ion, �ewe� ��oo�� o��e� �n�� ho��e� ho��i�� . RESULTS

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Outcome of segmental colonic resection for slow-transit constipation

Abstract: With a symptomatic relief comparable to that after ileorectal anastomosis and less severe side-effects, segmental colectomy may be a better alternative for selected patients with STC. Thorough preoperative evaluation is important and impaired rectal sensation may predict a poor outcome.

Cited by 79 publications

References 19 publications

Laparoscopic total colectomy for colonic inertia: surgical and functional results

Laparoscopic total colectomy for colonic inertia: surgical and functional results

Long-term results of subtotal colectomy with cecorectal anastomosis for isolated colonic inertia

Colonic exclusion and combined therapy for refractory constipation

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