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Colectomy as treatment for constipation in selected patients
M F Piccirillo1, P Reissman, S D Wexner
1Department of Colorectal Surgery, Cleveland Clinic Florida, Fort Lauderdale 33309, USA.
The British Journal of Surgery
|July 1, 1995
Summary
Total abdominal colectomy with ileorectal anastomosis (TAC) offers significant relief for colonic inertia patients. This surgery effectively improves bowel frequency and quality of life for most individuals with chronic constipation.
Area of Science:
- Gastroenterology
- Colorectal Surgery
Background:
- Chronic constipation affects a significant portion of the population.
- Colonic inertia is a severe form of chronic constipation characterized by slow transit.
- Surgical intervention may be considered for refractory cases.
Purpose of the Study:
- To prospectively evaluate the outcomes of total abdominal colectomy and ileorectal anastomosis (TAC) in patients diagnosed with colonic inertia.
- To assess the efficacy and safety of TAC as a treatment for this specific patient group.
Main Methods:
- Prospective evaluation of 54 patients (42 women, 12 men) with confirmed colonic inertia.
- Patients underwent total abdominal colectomy and ileorectal anastomosis (TAC).
- Outcomes were assessed based on bowel movement frequency and patient-reported satisfaction post-surgery.
Main Results:
- Preoperative bowel frequency averaged one movement every 8 days, often requiring laxatives or enemas.
- Postoperative follow-up (mean 27 months) showed a mean spontaneous bowel movement frequency of 3.7 per day.
- 94% of patients reported an 'excellent' or 'good' outcome, with significant improvement in bowel habits.
Conclusions:
- Total abdominal colectomy and ileorectal anastomosis (TAC) is a viable surgical option for patients suffering from colonic inertia.
- The procedure demonstrates acceptable morbidity and provides a high rate of satisfactory improvement in bowel function.
- TAC can significantly enhance the quality of life for individuals with severe, refractory chronic constipation due to colonic inertia.