[Efficacy comparison of subtotal colectomy with antiperistaltic cecoproctostomy and total colectomy with ileorectal anastomosis for patients with slow transit constipation].
OBJECTIVE
To compare the efficacy between subtotal colectomy with antiperistaltic cecoproctostomy and total colectomy with ileorectal anastomosis (TAC-IRA) for patients with severe refractory slow transit constipation(STC).


METHODS
During 1999 to 2002, TAC-IRA was the preferred procedure for 20 STC patients in our department. From 2003 to 2005, 17 STC patients underwent subtotal colectomy plus antiperistaltic cecoproctostomy. Clinical data of the two groups were collected and compared retrospectively.


RESULTS
There were no significant differences in basic preoperative clinical data between the two groups. During the follow-up period, the time of daily defecation in the antiperistaltic cecoproctostomy group was less than that of TAC-IRA group (2.4+/-0.9 vs 3.4+/-0.8, P=0.0014), meanwhile the Wexner continence score was significantly lower in the antiperistaltic cecoproctostomy group (4.3+/-1.8 vs 5.8+/-1.9, P=0.0223). Barium enema after subtotal colectomy showed that residual ascending colon and cecum presented a sign of "reservoir".


CONCLUSIONS
Subtotal colectomy with antiperistaltic cecoproctostomy is a better method for appropriately selected patients with STC than TAC-IRA.
Qian
Qun
Q
Department of Colorectal Surgery, Zhongnan Hospital, Wuhan University, Wuhan 430071, China. chqjiang@hotmail.com
Jiang
Cong-qing
CQ
Liu
Zhi-su
ZS
Ai
Zhong-li
ZL
He
Yue-ming
YM
Zheng
Ke-yan
KY
Wu
Yun-hua
YH
Tang
Sheng-li
SL
Tao
Qi
Q
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D002432:Cecum / Q000601:surgery*; D003082:Colectomy / Q000379:methods*; D003106:Colon / Q000601:surgery; D003248:Constipation / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012007:Rectum / Q000601:surgery*; D012189:Retrospective Studies