Long-term outcome after segmental colonic resection for slow transit constipation.

Area of Science:

• Gastroenterology
• Colorectal Surgery
• Surgical Outcomes

Background:

• Ileorectal anastomosis (IRA) is standard for slow transit constipation (STC).
• Hemicolectomy offers short-term benefits for STC, but long-term efficacy is unestablished.
• Evaluating long-term outcomes of hemicolectomy for STC is crucial.

Purpose of the Study:

• To assess the long-term efficacy and patient-reported outcomes of hemicolectomy for STC.
• To compare hemicolectomy results against established treatments for STC.
• To determine the durability of hemicolectomy's benefits in managing STC.

Main Methods:

• Fifty patients with STC underwent hemicolectomy (right- or left-sided) between 1993-2008.
• Colonic scintigraphy guided patient selection.
• Long-term follow-up included bowel function questionnaires and patient-reported outcome assessments for 43 patients.

Main Results:

• Median follow-up was 19.8 years; 13 patients (26%) were classified as failures.
• Stool frequency increased significantly (1/week to 5/week, p=0.001), and laxative use decreased (p=0.002).
• Patient global assessment showed 17 very good/good results, but 2 poor results; success rates ranged from 34% to 70%.

Conclusions:

• Hemicolectomy for STC improves bowel frequency and reduces laxative requirements.
• Long-term success is variable, influenced by definition of success and patient-reported outcomes.
• Further research is needed to optimize patient selection for hemicolectomy in STC.