title: Subtotal colectomy with antiperistaltic cecoproctostomy for selected patients with slow transit constipation-from Chinese report.
abstract: OBJECTIVE
  Total abdominal colectomy with ileorectal anastomosis (TAC-IRA) is recommended widely for the patients with severe, refractory slow transit constipation (STC). Subtotal colectomy with end-to-end antiperistaltic cecorectal anastomosis (Sarli procedure), an alternative for STC, has been paid particular attention. The purpose of this study was to retrospectively compare alterations of clinical functions and qualities of life between TAC-IRA and Sarli procedure.
  
  
  METHODS
  Seventeen patients with STC who underwent Sarli procedure and 20 patients with STC who underwent TAC-IRA were chosen for this study. Patient characteristics, operative data, postoperative data, alterations of clinical function, and quality of life were compared. The gastrointestinal quality of life index (GIQLI) survey was used to evaluate postoperative qualities of life.
  
  
  RESULTS
  At the mean 4-year follow-up (range 2-6 years), the frequency of daily bowel movement in the Sarli group was significantly less than that in the TAC-IRA group (2.4 +/- 0.9 vs. 3.4 +/- 0.8; P = 0.0014), and the Wexner continence scores were significantly lower in the Sarli group compared to the TAC-IRA group (4.3 +/- 1.8 vs. 5.8 +/- 1.9; P = 0.0223). However, the GIQLI score in Sarli group was higher than the TAC-IRA group (119.8 +/- 7.5 vs. 111.1 +/- 12.0, P = 0.0455). Post subtotal colectomy barium enema showed a sign of "reservoir" at the residual ascending colon and cecum.
  
  
  CONCLUSIONS
  Compared to the TAC-IRA, subtotal colectomy with end-to-end antiperistaltic cecoproctostomy for appropriately selected patients with STC resulted in relief of constipation, satisfactory functional outcome, and improved qualities of life.
authors.affiliation: Department of Colorectal Surgery, Zhongnan Hospital, Wuhan University, Wuhan, 430071, People's Republic of China. chqjiang@hotmail.com
authors.forename: Cong-Qing
authors.initials: CQ
authors.lastname: Jiang
authors.forename: Qun
authors.initials: Q
authors.lastname: Qian
authors.forename: Zhi-Su
authors.initials: ZS
authors.lastname: Liu
authors.forename: Gassimou
authors.initials: G
authors.lastname: Bangoura
authors.forename: Ke-Yan
authors.initials: KY
authors.lastname: Zheng
authors.forename: Yun-Hua
authors.initials: YH
authors.lastname: Wu
mesh_terms: D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D002432:Cecum / Q000601:surgery*; D002681:China; D002908:Chronic Disease; D003082:Colectomy / Q000379:methods*; D003248:Constipation / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005772:Gastrointestinal Transit / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012007:Rectum / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome