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[Surgical therapy of chronic constipation]
J Braun1, F P Pfingsten, J Fass
1Chirurgische Klinik Medizinischen Fakultät der RWTH Aachen.
Der Chirurg; Zeitschrift Fur Alle Gebiete Der Operativen Medizen
|February 1, 1991
Summary
Surgical colectomy offers significant improvement for severe constipation. Ileorectal anastomosis shows the greatest success probability, but careful patient selection is crucial due to potential complications.
Area of Science:
- Gastroenterology
- Surgical Gastroenterology
- Colorectal Surgery
Context:
- Intractable constipation significantly impacts patient quality of life.
- Surgical interventions are considered for conservative treatment failures.
- Evaluating surgical outcomes for severe constipation is essential.
Purpose:
- To review surgical treatment outcomes for conservative intractable constipation.
- To compare the efficacy of partial colectomy versus total colectomy.
- To identify the optimal surgical procedure for severe constipation.
Summary:
- Partial colectomy (sigmoid colectomy or left hemicolectomy) and total colectomy with various anastomoses were performed on 70 adult patients.
- Morbidity rates were 22.5% for partial and 54.5% for total colectomy, with small bowel obstruction as a frequent complication.
- Partial colectomy yielded good results in 75% of cases, while colectomy with ileorectal anastomosis achieved an 87.5% success rate, indicating its potential for severe cases.
Impact:
- Sigmoid colectomy or left hemicolectomy may be suitable for less severe constipation or recurrent sigmoid volvulus.
- Colectomy with ileorectal anastomosis appears most effective for severe constipation, necessitating careful patient selection.
- Findings guide surgical decision-making and highlight the need to balance efficacy with morbidity risks.