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Colectomy for slow transit constipation.

P V Walsh, D A Peebles-Brown, G Watkinson

    Annals of the Royal College of Surgeons of England
    |March 1, 1987
    PubMed
    Summary
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    Colectomy surgery for intractable constipation showed no mortality. While total colectomy with ileorectal anastomosis was preferred, permanent ileostomy was sometimes necessary, with long-term follow-up crucial for assessing outcomes.

    Area of Science:

    • Gastroenterology
    • Surgical Gastroenterology
    • Colorectal Surgery

    Background:

    • Intractable constipation significantly impacts patient quality of life.
    • Surgical intervention, including colectomy, is considered for refractory cases.
    • Evaluating surgical outcomes for severe constipation is essential.

    Purpose of the Study:

    • To report the outcomes of colectomy in patients with intractable constipation.
    • To assess the efficacy and complications of different colectomy procedures.

    Main Methods:

    • Retrospective case series of 21 patients (18 female) undergoing colectomy between 1976 and 1985.
    • Procedures included total colectomy with ileorectal anastomosis and permanent ileostomy.
    • Patient outcomes were assessed based on symptom resolution and functional results.

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    Main Results:

    • No surgical mortality was observed in the series.
    • Total colectomy with ileorectal anastomosis yielded satisfactory results in 12 out of 21 patients.
    • Five patients required a permanent ileostomy; megarectum did not preclude good results, but rectal stump function and anal sphincter relaxation were critical factors.

    Conclusions:

    • Colectomy can be a viable option for intractable constipation with no mortality.
    • Ileorectal anastomosis is not universally successful; permanent ileostomy may be required.
    • Long-term follow-up is necessary to detect late relapses and fully assess surgical outcomes.