Laparoscopic-assisted compared with open total colectomy in treating slow transit constipation

Area of Science:

• Colorectal Surgery
• Gastroenterology
• Surgical Techniques

Background:

• Slow transit constipation (STC) is a condition where total colectomy is the primary surgical intervention.
• Laparoscopic-assisted colectomy (LTC) presents a potential alternative to traditional open colectomy (OTC) for STC treatment.

Purpose of the Study:

• To compare the outcomes of laparoscopic-assisted colectomy (LTC) versus open colectomy (OTC) in patients with slow transit constipation (STC).

Main Methods:

• A historical control study comparing patients who underwent OTC versus LTC for STC.
• Data collected included intra-operative time, blood loss, ileus recovery, hospitalization, and complications.
• Patient-reported outcomes on bowel function and satisfaction were assessed post-operatively.

Main Results:

• Both OTC and LTC significantly improved stool frequency, need for assisted evacuation, and abdominal distension.
• Patient satisfaction with bowel function was high (96%) for both groups, though OTC patients reported lower cosmetic satisfaction.
• LTC had a longer mean operative time (74 min) but similar recovery and hospitalization durations compared to OTC.
• Complication rates were higher in LTC (43%) versus OTC (24%), with bowel obstruction being the primary complication in OTC patients.

Conclusions:

• Both open and laparoscopic colectomy are effective in improving bowel function for STC patients.
• Laparoscopic colectomy provides superior cosmetic outcomes but is associated with increased operative time.