title: Subtotal colectomy for colonic inertia.
abstract: The aim of this study was to assess the outcome of subtotal colectomy for colonic inertia (idiopathic slow transit constipation) that was resistant to laxative treatment. Twenty-four patients, 19 women and 5 men, with a mean age of 37 years, underwent subtotal colectomy with ileorectal or ascendo-rectal anastomosis. All patients were available for follow-up, with a mean follow-up of 23 months. Bowel frequency was significantly increased from 1.4+/-0.9 times per week to 22.8+/-9 times per week (average 3.2/day) after surgery (P <0.0001). The incidence of abdominal pain was decreased from 75% to 17%, as well as the severity (P <0.0001). Two patients who underwent ascendo-rectal anastomosis developed recurrent constipation. Two patients used antidiarrheal medication regularly. There was no major postoperative morbidity. Five patients were re-admitted due to small bowel obstruction; four received successful conservative management, and one required enterolysis. 'Excellent' or 'good' outcomes were reported by 21 patients (87.5%). Subtotal colectomy with ileorectal anastomosis produces satisfactory results in the majority of patients with proven colonic inertia.
authors.affiliation: Division of Colon and Rectal Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan.
authors.forename: C W
authors.initials: CW
authors.lastname: Fan
authors.forename: J Y
authors.initials: JY
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D003082:Colectomy / Q000379:methods*; D003106:Colon / Q000294:innervation*; D003109:Colonic Diseases, Functional / Q000175:diagnosis / Q000601:surgery; D003248:Constipation / Q000175:diagnosis* / Q000601:surgery*; D019841:Defecography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007082:Ileum / Q000601:surgery*; D008297:Male; D008365:Manometry; D008875:Middle Aged; D017060:Patient Satisfaction; D011336:Probability; D012007:Rectum / Q000601:surgery*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome