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Operative management of severe constipation
S J Lahr1, C J Lahr, A Srinivasan
1Department of Surgery, Medical University of South Carolina, Charleston, USA.
The American Surgeon
|December 22, 1999
Summary
Severe constipation requiring surgery can stem from colonic inertia, pelvic hiatal hernia, or both. Surgical correction of these conditions offers high patient satisfaction and improved bowel function.
Area of Science:
- Gastroenterology
- Colorectal Surgery
- Pelvic Floor Disorders
Background:
- Severe constipation necessitating surgical intervention is a complex condition.
- Potential underlying causes include colonic inertia and pelvic hiatal hernia.
- Understanding these etiologies is crucial for effective treatment.
Purpose of the Study:
- To investigate the causes and surgical outcomes of severe constipation.
- To evaluate the roles of colonic inertia and pelvic hiatal hernia in surgical constipation.
- To assess the efficacy of surgical interventions for these conditions.
Main Methods:
- Retrospective analysis of 201 patients undergoing major abdominal surgery for severe constipation.
- Evaluation of symptoms, anatomical findings (including pelvic hiatal hernia), and surgical procedures.
- Follow-up assessment of patient outcomes and complications.
Main Results:
- Colonic inertia and/or pelvic hiatal hernia were identified as causes in 196 patients.
- Pelvic hiatal hernia repair (PHHR) was performed in 44%, colectomy in 27%, and combined procedures in 29%.
- Overall symptom relief was achieved in 89.1% of patients with a 6.1% complication rate.
Conclusions:
- Severe surgical constipation can result from colonic inertia, pelvic hiatal hernia, or a combination.
- Preoperative evaluation is key to identifying these specific defects.
- Surgical correction leads to high patient satisfaction and improved bowel function.