Long-term follow up of abdominal rectosigmoidectomy with posterior end-to-side stapled anastomosis for Chagas megacolon.
OBJECTIVE
Chagas' disease is an endemic parasitosis found in Latin America. The disease affects different organs, such as heart, oesophagus, colon and rectum. Megacolon is the most frequent long-term complication, caused by damage to the myoenteric and submucous plexus, ultimately leading to a functional barrier to the faeces. Patients with severe constipation are managed surgically. The study aimed to analyse the 10-year minimum functional outcome after rectosigmoidectomy with posterior end-to-side anastomosis (RPESA).


METHODS
A total of 21 of 46 patients were available for follow up. Patients underwent clinical, radiological and manometric evaluation, and the results were compared with preoperative parameters.


RESULTS
Of the 21 patients evaluated, 81% (17) were female, with a mean age of 60.6 years. Good function was achieved in all patients, with significant improvement in defaecatory frequency (P < 0.0001), usage of enemas (P < 0.0001) and patient satisfaction. Barium enema also showed resolution of the colonic and rectal dilatation in 19 cases evaluated postoperatively.


CONCLUSIONS
Minimal 10-year follow up of RPESA showed excellent functional results, with no recurrence of constipation.
Nahas
S C
SC
Division of Colorectal Surgery, School of Medicine, University of São Paulo, São Paulo, Brazil. sergionahas@uol.com.br
Pinto
R A
RA
Dias
A R
AR
Nahas
C S R
CS
Araújo
S E A
SE
Marques
C F S
CF
Cecconello
I
I
D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000502:physiology; D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000379:methods; D014355:Chagas Disease / Q000150:complications*; D003106:Colon / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D012809:Colon, Sigmoid / Q000601:surgery*; D003248:Constipation / Q000601:surgery; D003672:Defecation; D013505:Digestive System Surgical Procedures / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D054368:Laxatives / Q000627:therapeutic use; D008297:Male; D008365:Manometry; D008531:Megacolon / Q000209:etiology / Q000469:parasitology / Q000601:surgery*; D008875:Middle Aged; D011859:Radiography; D012007:Rectum / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
D054368:Laxatives