Retrospective series of subtotal colonic bypass and antiperistaltic cecoproctostomy for the treatment of slow-transit constipation.
OBJECTIVE
Some popular surgical methods with big trauma to treat slow-transit constipation (STC) at present are far from satisfactory. This work is aimed to evaluate the clinical and functional outcomes of a redesigned procedure of subtotal colonic bypass and antiperistaltic cecoproctostomy (SCBAC) for the treatment of STC.


METHODS
The clinical data of 18 patients with severe idiopathic STC treated with SCBAC between September 2003 and September 2008 were retrospectively analyzed. The last eight patients accepted SCBAC were assessed by short form-36 (SF-36) scores translated into Chinese to inquire upon the quality of life before and 6 months after operation.


RESULTS
There were no procedure-related deaths in this series (mortality, 0%) or any serious complication. The average follow-up period was 17 months (range, 6-60 months). There was no intestinal occlusion due to adhesions that required surgery in all these patients. Scores for all SF-36 subscales were significantly higher for patients after operation than for before operation. A high number of patients (83%) expressed a willingness to repeat the procedure given the same preoperative conditions.


CONCLUSIONS
Our clinical practice demonstrates that the procedure of SCBAC is effective for the treatment of severe idiopathic STC in some cases. Due to its mild trauma and less operating time, SCBAC is almost well-tolerated and compatible in all age groups, making it worthy of further practice and investigation.
Wang
Yonggang
Y
Department of Colorectal Surgery, Shanxi Provincial People's Hospital, Taiyuan, The People's Republic of China, 030012. wygcp@163.com
Zhai
Chunbao
C
Niu
Liyun
L
Tian
Lijun
L
Yang
Jianyong
J
Hu
Zheng
Z
D000328:Adult; D000368:Aged; D000930:Antidiarrheals / Q000494:pharmacology* / Q000627:therapeutic use; D002432:Cecum / Q000000981:diagnostic imaging / Q000187:drug effects / Q000601:surgery*; D003106:Colon / Q000000981:diagnostic imaging / Q000187:drug effects / Q000601:surgery*; D003248:Constipation / Q000188:drug therapy / Q000503:physiopathology* / Q000601:surgery; D013505:Digestive System Surgical Procedures / Q000379:methods*; D005260:Female; D005772:Gastrointestinal Transit / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012007:Rectum / Q000000981:diagnostic imaging / Q000187:drug effects / Q000601:surgery*; D012189:Retrospective Studies; D013997:Time Factors
D000930:Antidiarrheals