Laparoscopic subtotal colectomy for colonic inertia.
Colonic inertia is an uncommon condition, usually occurring in women in the third decade of life. Severity of symptoms may lead some patients to a surgical consultation. This is a retrospective review of 14 patients who underwent laparoscopic subtotal colectomy for colonic inertia, performed by a single surgeon from August 1993 to November 2002. The mean age of the patients was 38.5 years (range 26-50 years); 93% of the patients were women. The common presenting symptoms included abdominal pain (93%), bloating (100%), constipation (100%), and nausea (57%). Median duration of symptoms before surgery was 4.5 years (range 1-30 years). Subtotal colectomy was completed laparoscopically in 13 patients. There was one conversion (7%) because of adhesions. Eleven patients (78.6%) had undergone previous abdominal surgery. The mean operating room time was 153 minutes (range 113-210 minutes). The median time to full bowel action was 2 days. One patient developed postoperative small bowel obstruction that required open exploration. Complete follow-up was available for 11 patients at a median follow-up of 18 months (range 2-96 months). Ninety-one percent of the patients reported excellent satisfaction with surgery, and their bowel movement frequency changed from 1.2 (+/-0.2) per week preoperatives to 17.2 (+/-2.9) per week postoperatively (P < 0.001). Three patients (27%) continued to report abdominal pain and 3 patients (27%) continued to require laxatives postoperatively. Laparoscopic subtotal colectomy provides excellent symptom relief in patients with colonic inertia who do not respond to medical measures.
Centre for Minimal Access Surgery, McMaster University, Hamilton, Ontario, Canada.
Cliff
C
Sample
Rohit
R
Gupta
Fahad
F
Bamehriz
Mehran
M
Anvari
D000328:Adult; D003082:Colectomy / Q000379:methods; D003109:Colonic Diseases, Functional / Q000175:diagnosis / Q000601:surgery*; D003248:Constipation / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005769:Gastrointestinal Motility; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D009864:Ontario; D010149:Postoperative Pain / Q000175:diagnosis; D011446:Prospective Studies; D020127:Recovery of Function; D012371:Robotics; D012720:Severity of Illness Index; D016896:Treatment Outcome