Colonic exclusion and combined therapy for refractory constipation.
OBJECTIVE
To investigate the therapeutic effectiveness of colonic exclusion and combined therapy for refractory constipation.


METHODS
Thirty-two patients with refractory constipation were randomly divided into treatment group (n = 14) and control group (n = 18). Fourteen patients in treatment group underwent colonic exclusion and end-to-side colorectal anastomosis. Eighteen patients in control group received subtotal colectomy and end-to-end colorectal anastomosis. The therapeutic effects of the operations were assessed by comparing the surgical time, incision length, volume of blood losses, hospital stay, recovery rate and complication incidence. All patients received long-term follow-up.


RESULTS
All operations were successful and patients recovered fully after the operations. In comparison of treatment group and control group, the surgical time (h), incision length (cm), volume of blood losses (mL), hospital stay (d) were 87 +/- 16 min vs 194 +/- 23 min (t = 9.85), 10.4 +/- 0.5 cm vs 21.2 +/- 1.8 cm (t = 14.26), 79.5 +/- 31.3 mL vs 286.3 +/- 49.2 mL (t = 17.24), and 11.8 +/- 2.4 d vs 18.6 +/- 2.6 d (t = 6.91), respectively (P < 0.001 for all). The recovery rate and complication incidence were 85.7% vs 88.9% (P = 0.14 > 0.05), 21.4% vs 33.3% (P = 0.73 > 0.05), respectively.


CONCLUSIONS
Colonic exclusion has better therapeutic efficacy on refractory constipation. It has many advantages such as shorter surgical time, smaller incision, fewer blood losses and shorter hospital stay.
Peng
Hong-Yun
HY
Department of General Surgery, The Second Affiliated Hospital, Nanchang University, Nanchang 330006, Jiangxi Province, China. penghongyun0855@sina.com
Xu
Ai-Zhong
AZ
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D002400:Cathartics / Q000627:therapeutic use; D003082:Colectomy / Q000009:adverse effects / Q000379:methods*; D003106:Colon / Q000503:physiopathology / Q000601:surgery; D003248:Constipation / Q000209:etiology / Q000503:physiopathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012007:Rectum / Q000601:surgery
D002400:Cathartics