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Related Experiment Videos

Surgery for constipation: a review

J Pfeifer1, F Agachan, S D Wexner

  • 1Department of Colorectal Surgery, Cleveland Clinic Florida, Fort Lauderdale 33309, USA.

Diseases of the Colon and Rectum
|April 1, 1996
PubMed
Summary
This summary is machine-generated.

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Surgical options for intractable constipation, including colonic inertia and pelvic outlet obstruction, offer variable success. Thorough preoperative testing is essential for successful outcomes, as surgery is rarely needed.

Area of Science:

  • Gastroenterology
  • Colorectal Surgery
  • Physiology

Background:

  • Intractable constipation often stems from colonic inertia (CI) or pelvic outlet obstruction (POO).
  • Understanding the interplay of motility disorders and functional defecation problems is key.
  • This review examines the pathophysiology and surgical management of severe constipation.

Purpose of the Study:

  • To review the physiologic and pathophysiologic changes in patients with intractable constipation.
  • To provide an overview of surgical treatment options for complex constipation.

Main Methods:

  • Literature review of surgical interventions for constipation.
  • Analysis of outcomes for various surgical procedures based on constipation etiology.

Related Experiment Videos

Main Results:

  • Subtotal colectomy is effective for CI, but 10% experience persistent symptoms.
  • Pelvic outlet obstruction (POO) responds well to biofeedback; surgery is successful for rectocele/sigmoidocele.
  • Mixed results for megabowel/megacolon surgeries; sigmoid colectomy effective for isolated sigmoid distension.
  • Combined CI and POO require conservative POO treatment before colectomy for optimal results.

Conclusions:

  • Surgical intervention for intractable constipation is infrequently required.
  • Comprehensive preoperative physiologic evaluation is crucial for successful management.