Document Detail

Pilot study of subtotal colectomy with antiperistaltic cecoproctostomy for the treatment of chronic slow-transit constipation.
MedLine Citation:
PMID:  11598483     Owner:  NLM     Status:  MEDLINE    
PURPOSE: Functional results of total colectomy with ileorectal anastomosis for the treatment of chronic constipation caused by colonic inertia are often considered unsatisfactory because of the frequency of postoperative diarrhea and the high rate of postoperative small-bowel obstruction. Patients affected by severe colonic inertia underwent a subtotal colectomy with a novel antiperistaltic cecorectal anastomosis. The aim of the study was to assess the functional results after preservation of the cecorectal junction. METHODS: Eight females affected by isolated colonic inertia and two females with both paradoxical puborectalis contraction and colonic inertia, of a median age of 40 years, underwent subtotal colectomy with antiperistaltic cecorectal anastomosis. Before antiperistaltic cecorectal anastomosis all ten patients were laxative-dependant, with a mean bowel frequency of ten days; eight of them (80 percent) had distention, seven (70 percent) bloating, and three (30 percent) abdominal pain. RESULTS: There was no mortality or major postoperative morbidity. One month after antiperistaltic cecorectal anastomosis, bowel frequency was a mean of 2.2 (range, 1-4) per day, with a semiliquid stool consistency. After one year, bowel frequency was a mean of 1.3 (range, 0.5-3) per day, with a solid stool consistency; the same results were recorded at last follow-up. Although no patients used antidiarrheal medicine, laxatives continued to be used by both patients with paradoxical puborectalis contraction. All ten (100 percent) of the patients reported a good or improved quality of life. CONCLUSION: This preliminary experience seems to show that antiperistaltic cecorectal anastomosis is safe and effective for patients with colonic inertia. It results in prompt and prolonged relief from constipation for patients with isolated colonic inertia.
L Sarli; R Costi; D Sarli; L Roncoroni
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Diseases of the colon and rectum     Volume:  44     ISSN:  0012-3706     ISO Abbreviation:  Dis. Colon Rectum     Publication Date:  2001 Oct 
Date Detail:
Created Date:  2001-10-12     Completed Date:  2001-10-25     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0372764     Medline TA:  Dis Colon Rectum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1514-20     Citation Subset:  IM    
Institute of General Surgery, University of Parma, School of Medicine, Parma, Italy.
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MeSH Terms
Anastomosis, Surgical
Cecum / surgery
Chronic Disease
Colectomy / methods*
Constipation / surgery*
Gastrointestinal Transit
Middle Aged
Pilot Projects
Rectum / surgery
Treatment Outcome

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

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