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Related Experiment Videos

[Surgical management for slow-transit constipation].

A Alves1, B Coffin, Y Panis

  • 1Service de chirurgie digestive, hôpital Lariboisière, 2, rue Ambroise-Paré, 75010 Paris, France. arnaud.alves@lrb.ap-ho-paris.fr

Annales De Chirurgie
|September 25, 2004
PubMed
Summary
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Surgical intervention for slow-transit constipation is reserved for a small percentage of patients unresponsive to medical therapy. Preoperative assessments are crucial for patient selection, though surgery offers improvement in only two-thirds of cases.

Area of Science:

  • Gastroenterology
  • Colorectal Surgery

Context:

  • Slow-transit constipation (STC) is a debilitating condition impacting colonic motility.
  • Medical management fails in a significant proportion of STC patients, necessitating further treatment considerations.

Purpose:

  • To outline the current surgical approach for STC.
  • To detail the essential preoperative investigations for patient selection.
  • To report the efficacy and potential complications of surgical intervention for STC.

Summary:

  • Less than 10% of patients with STC require surgery after medical treatment failure.
  • Preoperative investigations including colonic transit tests, anorectal manometry, and defecography are mandatory for patient selection.
  • Subtotal colectomy with ileorectal anastomosis, potentially laparoscopic, is the current surgical standard for STC.

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Impact:

  • Surgical management improves STC in approximately two-thirds of patients.
  • Potential postoperative complications include small bowel obstruction (25%), abdominal pain (50%), and constipation recurrence (10%).
  • Careful patient selection is vital to optimize surgical outcomes and minimize adverse events.