Severe slow-transit constipation following radical hysterectomy

Area of Science:

• Gastroenterology
• Surgical Oncology
• Colorectal Surgery

Background:

• Radical hysterectomy, a treatment for gynecologic cancers, can lead to severe post-operative complications.
• Slow-transit constipation is a debilitating condition characterized by significantly delayed colonic transit time.
• Management of severe constipation post-hysterectomy often presents therapeutic challenges.

Observation:

• Two patients presented with severe, invalidating slow-transit constipation after undergoing radical hysterectomy.
• Conservative management strategies failed to provide adequate relief for their symptoms.
• The patients' quality of life was significantly impaired by the persistent constipation.

Findings:

• Both patients underwent a left-sided hemicolectomy as a surgical intervention.
• Following the hemicolectomy, both patients experienced dramatic and sustained improvement in their constipation symptoms.
• The surgical approach effectively addressed the underlying pathophysiology contributing to the slow-transit constipation.

Implications:

• Left-sided hemicolectomy may represent a viable and effective treatment option for select patients suffering from severe slow-transit constipation post-radical hysterectomy.
• This case series highlights the potential benefits of surgical intervention in managing refractory functional bowel disorders following major pelvic surgery.
• Further research is warranted to explore the long-term efficacy and patient selection criteria for hemicolectomy in this specific patient population.