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Surgery for slow transit constipation: are we helping patients?

M Zutshi¹, T L Hull, R Trzcinski

¹Department of Colorectal Surgery, Cleveland Clinic Foundation, Desk A-30, 9500 Euclid Avenue, Cleveland, OH 44195, USA. zutshim@ccf.org

International Journal of Colorectal Disease

|September 1, 2006

Summary

Surgery for slow transit constipation offers long-term benefits for many patients, with 77% reporting improvement. However, mental health aspects of quality of life may be impacted, necessitating careful patient selection.

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Area of Science:

Gastroenterology
Colorectal Surgery
Surgical Outcomes

Background:

Long-term outcomes following surgical intervention for slow transit constipation (STC) remain debated.
Assessing the long-term quality of life (QoL) is crucial for understanding the full impact of STC surgery.

Purpose of the Study:

To evaluate the long-term quality of life (QoL) in patients who underwent colectomy with ileorectal anastomosis for slow transit constipation.
To identify factors influencing QoL and surgical outcomes in this patient cohort.

Main Methods:

Retrospective review of medical records for patients who had colectomy with ileorectal anastomosis (1983-1998).
Data collection included preoperative, operative, and postoperative details.
Long-term QoL assessment using the Short-Form (SF)-36 survey and a custom symptom questionnaire.

Main Results:

A total of 69 patients were analyzed with a median follow-up of 10.8 years.
Long-term complications occurred in 46% of patients, including small bowel obstruction (20%).
While physical QoL (SF-36 physical component) was comparable to healthy individuals, mental QoL (SF-36 mental component) was significantly lower, particularly in vitality and social functioning.

Conclusions:

Colectomy with ileorectal anastomosis can lead to long-term improvement in symptoms for a majority of patients (77% reported benefit).
Preoperative symptoms may persist post-surgery, and potential complications should be considered.
The mental health component of QoL warrants attention in the long-term management of patients undergoing surgery for STC.