[Laparoscopic therapy of chronic constipation].
Chronic constipation is a common complaint. Clinical presentation varies with each individual. This study reports the results of laparoscopic therapy in 92 patients with chronic constipation. In two patients conversion was necessary. The majority of patients were female (n = 84, 93.3%). Mean age was 60.3 years (+/- 15.7). In three patients with slow-transit constipation a laparoscopic assisted subtotal colectomy was performed. In patients with outlet obstruction a laparoscopic assisted sigmoid resection was carried out, whereas in 79 a rectopexy with reconstruction of the pouch of douglas was added. In 6 of 8 patients with concomitting diverticulitis an anterior resection was necessary. Mean stay on ICU was 0.5 days. OR time ranged from 100 up to 490 minutes. In 21 patients (23.4%) postoperative complications were observed; however only in 7.8% (n = 7) this lead to additional surgical intervention. The postoperative follow-up is 24 months (6-52 mon). In 76.3% of patients with outlet obstruction and rectal prolapse chronic constipation postoperatively improved or patients felt "symptomfree". In patients with outlet obstruction but without rectal prolapse constipation postoperatively was better in 75.8%. After subtotal colectomy 2 of 3 patients (66%) felt cured after surgery. Careful patients selection by thorough preoperative physiologic testing is mandatory for successful outcome in surgery of chronic constipation. Based on this by laparoscopic surgery same functional results as with conventional open technique could be achieved.
Schiedeck
T H
TH
Klinik für Chirurgie, Medizinische Universität zu Lübeck.
Schwandner
O
O
Bruch
H P
HP
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D003248:Constipation / Q000209:etiology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome