title: Long-term results of subtotal colectomy with cecorectal anastomosis for isolated colonic inertia.
abstract: OBJECTIVE
  To evaluate the results of sub total colectomy with cecorectal anastomosis (STC-CRA) for isolated colonic inertia (CI).
  
  
  METHODS
  Fourteen patients (mean age 57.5 +/- 16.5 year) underwent surgery for isolated CI between January 1986 and December 2002. The mean frequency of bowel motions with the aid of laxatives was 1.2 +/- 0.6 per week. All subjects underwent colonoscopy, anorectal manometry, cinedefaecography and colonic transit time (CTT). CI was defined as diffuse markers delay on CTT without evidence of pelvic floor dysfunction. All patients underwent STC-CRA. Long-term follow-up was obtained prospectively by clinical visits between October 2005 and February 2006 at a mean of 10.5 +/- 3.6 years (range 5-16 years) during which we considered the number of stool emissions, the presence of abdominal pain or digitations, the use of pain killers, laxatives and/or fibers. Patients were also asked if they were satisfied with the surgery.
  
  
  RESULTS
  There was no postoperative mortality. Postoperative complications occurred in 21.4% (3/14). At the end of follow-up, bowel frequency was significantly (P < 0.05) increased to a mean of 4.8 +/- 7.5 per day (range 1-30). One patient reported disabling diarrhea. Two patients used laxatives less than three times per month without complaining of what they called constipation. Overall, 78.5% of patients would have chosen surgery again if necessary.
  
  
  CONCLUSIONS
  STC-CRA is feasible and safe in patients with CI achieving 79% of success at a mean follow-up of 10.5 years. A prospective controlled evaluation is warranted to verify the advantages of this surgical approach in patients with CI.
authors.affiliation: Service de Chirurgie Digestive, Université de Nice-Sophia-Antipolis, Faculté de Médicine, Nice, France.
authors.forename: Antonio
authors.initials: A
authors.lastname: Iannelli
authors.forename: Thierry
authors.initials: T
authors.lastname: Piche
authors.forename: Raffaella
authors.initials: R
authors.lastname: Dainese
authors.forename: Pascal
authors.initials: P
authors.lastname: Fabiani
authors.forename: Albert
authors.initials: A
authors.lastname: Tran
authors.forename: Jean
authors.initials: J
authors.lastname: Mouiel
authors.forename: Jean
authors.initials: J
authors.lastname: Gugenheim
mesh_terms: D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D002432:Cecum / Q000601:surgery*; D003082:Colectomy / Q000379:methods*; D003248:Constipation / Q000601:surgery*; D005260:Female; D005772:Gastrointestinal Transit; D006801:Humans; D008297:Male; D008875:Middle Aged; D012007:Rectum / Q000601:surgery*