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Colectomy for severe slow-transit constipation in strictly selected patients
J Christiansen1, O O Rasmussen
1Dept. of Surgery D, Herlev Hospital, University of of Copenhagen, Denmark.
Scandinavian Journal of Gastroenterology
|August 1, 1996
Summary
Colectomy can relieve severe constipation in carefully selected patients. However, high rectal volume tolerability may predict postoperative rectal inertia, a potential surgical contraindication.
Area of Science:
- Gastroenterology
- Colorectal Surgery
Background:
- Colectomy for severe constipation yields unsatisfactory results in up to 25% of patients.
- Rectal dysfunction is a common cause of treatment failure after colectomy for constipation.
Purpose of the Study:
- To evaluate the effectiveness of colectomy in patients meeting strict criteria for a favorable outcome in severe constipation.
Main Methods:
- Twelve patients with severe, long-standing constipation and normal rectal function underwent colectomy.
- Patients had demonstrable slow-transit constipation unresponsive to conservative treatments.
Main Results:
- Ten of twelve patients experienced relief from constipation.
- Two patients remained constipated; one with high rectal compliance later benefited from proctectomy and ileo-pouch-anal anastomosis.
- Postoperative complications included abdominal pain, diarrhea, and incontinence in some patients.
Conclusions:
- Subtotal or segmental colectomy is a viable option for select severe constipation patients meeting strict criteria.
- Excessively high rectal volume tolerability, despite normal emptying, may indicate a risk of postoperative rectal inertia and contraindicate surgery.