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Outcome of colectomy for slow transit constipation
C H Knowles1, M Scott, P J Lunniss
1Academic Department of Surgery, St Bartholomew's and the Royal London School of Medicine & Dentistry, Whitechapel, London, United Kingdom.
Objective:
To review the outcome data for colectomy performed for patients with slow transit constipation (STC).
Background:
The outcome of surgical intervention in patients with STC is unpredictable. This may be a consequence of the lack of effectiveness of such interventions or may reflect heterogeneity within this group of patients.
Methods:
The authors reviewed the data of all series in the English language that document the outcome of colectomy in > or = 10 patients in the treatment of STC.
Results:
Thirty-two series fulfilled the entry criteria. There was widespread variability in patient satisfaction rates after colectomy (39% to 100%), reflecting large differences in the incidence of postoperative complications and in long-term functional results. Outcome was dependent on several clinical and pathophysiologic findings and on the type of study, the population studied, and the surgical procedure used.
Conclusions:
It may be possible to predict outcome on the basis of preoperative clinical and pathophysiologic findings. This review suggests a rationale for the selection of patients for colectomy.