[Comparison of subtotal colectomy with antiperistaltic cecoproctostomy and total colectomy with ileoproctostomy in treating slow transit constipation].
OBJECTIVE
To compare clinical outcome and quality of life of subtotal colectomy with antiperistaltic cecoproctostomy and total colectomy with ileorectal anastomosis (TAC-IRA) in patients with severe slow transit constipation (STC).


METHODS
Of the 56 patients enrolled in this study from January 1999 to June 2008, 32 cases underwent subtotal colectomy with antiperistaltic cecoproctostomy, and 20 patients underwent TAC-IRA. The patients' clinical characteristics, operative data, postoperative outcome, functional result and gastrointestinal quality of life index (GIQLI) survey were compared between the two groups.


RESULTS
All patients were followed up for 1-7 years (median, 4 years). The basic clinical characteristics between the two groups was comparable. During the follow-up period, the number of daily bowel movements in the subtotal colectomy group was significantly fewer than that in TAC-IRA group (2.5+/-0.8 vs. 3.4+/-0.8; P=0.000). The Wexner continence score was significantly lower in subtotal colectomy group (4.4+/-1.6 vs. 5.8+/-1.9; P=0.011), and the GIQLI score in subtotal colectomy group was significantly higher than that in the TAC-IRA group (120.7+/-7.5 vs. 111.1+/-12.0; P=0.005).


CONCLUSIONS
Subtotal colectomy with antiperistaltic cecoproctostomy appeared to be the superior treatment than the TAC-IRA for selected patients with slow transit constipation for improved functional outcomes and quality of life.
Qian
Qun
Q
Department of Colorectal Surgery, Zhongnan Hospital of Wuhan University, Wuhan 430071, China.
Jiang
Cong-qing
CQ
Zhang
Ya-jie
YJ
Liu
Zhi-su
ZS
Wu
Yun-hua
YH
Zheng
Ke-yan
KY
He
Yue-ming
YM
Ai
Zhong-li
ZL
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods*; D002432:Cecum / Q000601:surgery; D003082:Colectomy / Q000379:methods*; D003248:Constipation / Q000601:surgery*; D005260:Female; D006801:Humans; D007082:Ileum / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012007:Rectum / Q000601:surgery; D012189:Retrospective Studies; D016896:Treatment Outcome