title: Functional outcomes and quality of life in patients treated with laparoscopic total colectomy for colonic inertia.
abstract: OBJECTIVE
  To assess the functional outcomes and quality of life in patients with laparoscopic total colectomy for slow-transit constipation (STC).
  
  
  METHODS
  All patients undergoing laparoscopic colectomy with ileorectal anastomosis for colonic inertia at two referral centers were analyzed. Their preoperative, intraoperative and postoperative details were recorded with a one-year follow-up. Their quality of life was assessed using the SF-36 questionnaire.
  
  
  RESULTS
  Between 2004 and 2007, 710 patients were evaluated. Eight female patients (1.1 %) fulfilled the criteria for STC without obstructive defecation syndrome. Their mean age was 38 years ± 15 (range from 22 to 62). The conversion rate was 12.5 %. The morbidity rate was 37.5 %, and mortality was nil. The preoperative abdominal pain was 6.6 ± 0.3 and had decreased to 3.6 ± 2.3 postoperatively (P = 0.008). At 1 year, the defecation frequency per week had increased from 0.84 ± 0.24 to 6.75 ± 3.4 (P = 0.001). Three patients developed nocturnal leakage (37.5 %). Eighty-eight percent of the patients recommend the procedure. All parameters of the SF-36 questionnaire had improved at the one-year follow-up examination.
  
  
  CONCLUSIONS
  Laparoscopic colectomy for slow-transit constipation is safe and increased the number of evacuations per week. Although nocturnal leakage may occur, these patients experience improvements in their quality of life.
authors.affiliation: Division of Surgery, Colorectal Surgery Service, Instituto Nacional de Ciencias Medicas y Nutricion "Salvador Zubiran", CP 14000, Mexico City, Mexico, omarvergara74@hotmail.com.
authors.forename: Omar
authors.initials: O
authors.lastname: Vergara-Fernandez
authors.forename: Rabí
authors.initials: R
authors.lastname: Mejía-Ovalle
authors.forename: Noel
authors.initials: N
authors.lastname: Salgado-Nesme
authors.forename: Nathalie
authors.initials: N
authors.lastname: Rodríguez-Dennen
authors.forename: Javier
authors.initials: J
authors.lastname: Pérez-Aguirre
authors.forename: Víctor Hugo
authors.initials: VH
authors.lastname: Guerrero-Guerrero
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Sánchez-Robles
authors.forename: Miguel Angel
authors.initials: MA
authors.lastname: Valdovinos-Díaz
mesh_terms: D000328:Adult; D057868:Anastomotic Leak / Q000453:epidemiology / Q000209:etiology; D003082:Colectomy / Q000009:adverse effects / Q000379:methods*; D003248:Constipation / Q000503:physiopathology / Q000601:surgery*; D003672:Defecation; D005260:Female; D005500:Follow-Up Studies; D005769:Gastrointestinal Motility; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult