Document Detail


Outcome of segmental colonic resection for slow-transit constipation.
MedLine Citation:
PMID:  12296895     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The standard surgical treatment for slow-transit constipation (STC) is subtotal colectomy and ileorectal anastomosis. A segmental resection may serve the same purpose, but with a reduced risk of side-effects such as diarrhoea or incontinence. The aim of this study was to evaluate the functional results following segmental resection in a consecutive series of patients with STC. METHODS: Selection criteria included prolonged segmental transit on oral 111In-labelled diethylene triamine penta-acetic acid scintigraphic transit study, and disabling symptoms resistant to medical therapy and treatment of outlet obstruction. Twenty-eight patients (26 women, median age 52 years) were treated with segmental resection and followed prospectively with a validated questionnaire. RESULTS: After a median of 50 (range 16-78) months, 23 patients were pleased with the outcome. The median (range) stool frequency increased from 1 (0-7) to 7 (0-63) per week (P < 0.001). The number of patients passing hard stools and straining excessively decreased (P = 0.016 and P = 0.041, respectively). The median incontinence score was unchanged. Rectal sensory thresholds were higher in patients in whom the treatment failed (P < 0.001). CONCLUSION: With a symptomatic relief comparable to that after ileorectal anastomosis and less severe side-effects, segmental colectomy may be a better alternative for selected patients with STC. Thorough preoperative evaluation is important and impaired rectal sensation may predict a poor outcome.
Authors:
E Lundin; U Karlbom; L Påhlman; W Graf
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The British journal of surgery     Volume:  89     ISSN:  0007-1323     ISO Abbreviation:  Br J Surg     Publication Date:  2002 Oct 
Date Detail:
Created Date:  2002-09-25     Completed Date:  2002-11-08     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0372553     Medline TA:  Br J Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  1270-4     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, University Hospital, S-751 85 Uppsala, Sweden. erik.lundin@kirurgi.uu.se
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MeSH Terms
Descriptor/Qualifier:
Adult
Colectomy / methods*
Colonic Diseases / physiopathology,  surgery*
Constipation / physiopathology,  surgery*
Defecation / physiology
Female
Follow-Up Studies
Gastrointestinal Transit / physiology
Humans
Length of Stay
Male
Manometry
Middle Aged
Patient Satisfaction
Prospective Studies
Sensory Thresholds
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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