Aim: To evaluate the results of sub total colectomy with cecorectal anastomosis (STC-CRA) for isolated colonic inertia (CI).
Methods: Fourteen patients (mean age 57.5 +/- 16.5 year) underwent surgery for isolated CI between January 1986 and December 2002. The mean frequency of bowel motions with the aid of laxatives was 1.2 +/- 0.6 per week. All subjects underwent colonoscopy, anorectal manometry, cinedefaecography and colonic transit time (CTT). CI was defined as diffuse markers delay on CTT without evidence of pelvic floor dysfunction. All patients underwent STC-CRA. Long-term follow-up was obtained prospectively by clinical visits between October 2005 and February 2006 at a mean of 10.5 +/- 3.6 years (range 5-16 years) during which we considered the number of stool emissions, the presence of abdominal pain or digitations, the use of pain killers, laxatives and/or fibers. Patients were also asked if they were satisfied with the surgery.
Results: There was no postoperative mortality. Postoperative complications occurred in 21.4% (3/14). At the end of follow-up, bowel frequency was significantly (P < 0.05) increased to a mean of 4.8 +/- 7.5 per day (range 1-30). One patient reported disabling diarrhea. Two patients used laxatives less than three times per month without complaining of what they called constipation. Overall, 78.5% of patients would have chosen surgery again if necessary.
Conclusion: STC-CRA is feasible and safe in patients with CI achieving 79% of success at a mean follow-up of 10.5 years. A prospective controlled evaluation is warranted to verify the advantages of this surgical approach in patients with CI.
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http://dx.doi.org/10.3748/wjg.v13.i18.2590 | DOI Listing |
Zhonghua Wei Chang Wai Ke Za Zhi
December 2024
Department of General Surgery, the Army Medical Center (Daping Hospital), Chongqing400042, China.
Although the surgical treatment of slow transit constipation (STC) has been around for over a century, the choice of surgical method is still controversial. Specifically, the two most widely used operations in the world are total colectomy ileorectostomy (TC-IRA) and subtotal colectomy. Subtotal colectomy offers many methods for anastomosis, including ileocecal and cecorectal anastomoses and so on.
View Article and Find Full Text PDFColorectal Dis
May 2024
Department of Medicine and Surgery, University of Parma, Parma, Italy.
Updates Surg
April 2024
Department of Gastroenterology and Anorectal Surgery, Longyan First Affiliated Hospital of Fujian Medical University, No. 105 Jiuyi North Road, Longyan, 364000, Fujian, China.
Surgical treatment has been widely used in patients with refractory slow transit constipation (RSTC). The aim of this network meta-analysis (NMA) was to compare the effects of different colectomies on short-term postoperative complications and quality of life in patients with RSTC. Electronic literature searches were performed in the PubMed, Web of Science, EMBASE, WANFANG DATA, and Cochrane Central Register of controlled trials databases and were searched up to December 2022.
View Article and Find Full Text PDFUpdates Surg
June 2023
Department of Gastrointestinal Surgery, The First Affiliated Hospital of Zhengzhou University, 1 Jianshe Road, Zhengzhou, 450052, China.
To investigate the clinical efficacy of laparoscopic total colectomy with ileorectal anastomosis (TC-IRA) and laparoscopic subtotal colectomy with antiperistaltic cecorectal anastomosis (SC-ACRA) on adults with slow transit constipation (STC). One hundred and three patients with STC were assigned to the TC-IRA group (n = 53) and the SC-ACRA group (n = 50). The clinical data were analyzed.
View Article and Find Full Text PDFInt J Colorectal Dis
March 2022
Department of Surgery, Mezourlo, University Hospital of Larissa, Larissa, 41110, Greece.
Introduction: We conducted this meta-analysis, to compare cecorectal (CRA) and ileorectal anastomosis (IRA), regarding perioperative safety and efficacy, in patients submitted to colectomy for refractory slow transit constipation (STC).
Methods: This study followed the Cochrane Handbook for Systematic Reviews of Interventions and the PRISMA guidelines. To identify all eligible records, a systematic literature search in the electronic scholar databases (Medline, Scopus, Web of Science) was performed.
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