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Subtotal colectomy for colonic inertia.

C W Fan¹, J Y Wang

¹Division of Colon and Rectal Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan.

International Surgery

|October 9, 2001

Summary

Subtotal colectomy significantly improved bowel frequency and reduced abdominal pain in patients with severe colonic inertia (idiopathic slow transit constipation). This surgical intervention offers a high rate of satisfactory outcomes for refractory cases.

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Area of Science:

Gastroenterology
Colorectal Surgery

Background:

Colonic inertia, a severe form of idiopathic slow transit constipation, often proves resistant to conservative treatments like laxatives.
Surgical intervention, such as subtotal colectomy, is considered for patients with debilitating symptoms unresponsive to medical management.

Purpose of the Study:

To evaluate the efficacy and outcomes of subtotal colectomy in patients diagnosed with colonic inertia.
To assess the impact of surgery on bowel frequency, abdominal pain, and overall patient satisfaction.

Main Methods:

A cohort of 24 patients (19 female, 5 male) with refractory colonic inertia underwent subtotal colectomy with either ileorectal or ascendo-rectal anastomosis.
Patients were followed for a mean of 23 months to assess postoperative outcomes, including bowel function, pain levels, and complications.

Main Results:

Post-surgery, weekly bowel frequency increased significantly from 1.4 to 22.8 (P <0.0001), averaging 3.2 bowel movements daily.
Abdominal pain incidence and severity decreased significantly, from 75% to 17% (P <0.0001).
Overall, 87.5% of patients reported 'excellent' or 'good' outcomes, with low rates of major morbidity, though 5 patients experienced small bowel obstruction.

Conclusions:

Subtotal colectomy with ileorectal anastomosis is an effective treatment for colonic inertia, yielding significant improvements in bowel function and symptom relief.
The procedure demonstrates a high success rate and patient satisfaction, making it a viable option for carefully selected patients with severe, refractory constipation.

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