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Long-term outcome after segmental colonic resection for slow transit constipation
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- Tsimogiannis, Konstantinos (author)
- Uppsala universitet,Gastrointestinalkirurgi
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- Karlbom, Urban (author)
- Uppsala universitet,Gastrointestinalkirurgi
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- Lundin, Erik (author)
- Uppsala universitet,Gastrointestinalkirurgi
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- 2019-04-01
- 2019
- English.
- In: International Journal of Colorectal Disease. - : SPRINGER. - 0179-1958 .- 1432-1262. ; 34:6, s. 1013-1019
- Journal article (peer-reviewed)
Abstract
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- PurposeColectomy with ileorectal anastomosis (IRA) is the most common surgical procedure for slow transit constipation (STC). A hemicolectomy has been suggested as an alternative to IRA with good short-term results. However, long-term results are unknown. The aim of this study was to evaluate the long-term results after hemicolectomy as a treatment for STC.MethodsFifty patients with STC were selected for right- or left-sided hemicolectomy after evaluation with colonic scintigraphy from 1993 to 2008. Living patients (n=43) received a bowel function questionnaire and a questionnaire about patient-reported outcome.ResultsAfter a median follow-up of 19.8years, 13 patients had undergone rescue surgery (n=12) or used irrigation (n=1) and were classified as failures. In all, 30 were evaluable for functional outcome and questionnaire data for 19 patients (due to 11 non-responding) could be analysed. Two reported deterioration after several years and were also classified as failures. Median stool frequency remained increased from 1 per week at baseline to 5 per week at long-term follow-up (p=0.001). Preoperatively, all patients used laxatives, whereas 12 managed without laxatives at long-term follow-up (p=0.002). There was some reduction in other constipation symptoms but not statically significant. In the patients' global assessment, 10 stated a very good result, seven a good result and two a poor result.ConclusionsHemicolectomy for STC increases stool frequency and reduces laxative use. Long-term success rate could range between 17/50 (34%) and 35/50 (70%) depending on outcome among non-responders.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Gastroenterologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Gastroenterology and Hepatology (hsv//eng)
Keyword
- Slow transit constipation
- Segmental resection
- Colonic functional disorders
- Long-term follow-up
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- ref (subject category)
- art (subject category)
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