title: Treating symptomatic adhesions to the sigmoid colon: colectomy improves quality of life.
abstract: BACKGROUND
  When severe chronic pelvic pain, constipation, and bloating are due to dense pelvic adhesions fixing the sigmoid loops, patients may be offered the option of sigmoid colectomy. This study examines the effectiveness of colectomy in the treatment of such patients.
  
  
  METHODS
  Patients were identified from a surgical database, demographic data were abstracted, and charts were reviewed. Patients were interviewed postoperatively. Primary end points were morbidity, length of stay, change in bowel habit, and patient satisfaction.
  
  
  RESULTS
  There were 46 patients (44 women) with a mean age of 54.7 years (±14.3). Forty-three had a history of prior pelvic surgery (93%), including 30 (65%) with hysterectomy. One quarter had been diagnosed with irritable bowel syndrome. Surgery revealed adhesive tethering of the sigmoid colon in 43 patients (94%). Mean length of stay was 6.5 days (±2.5), and complications occurred in eight (17.3%) patients. There were no deaths, and no patients required a stoma. Follow-up in 37 patients after mean of 7.2(±5.0) years showed significant reductions in abdominal pain and bloating postoperatively, with normalization of bowel function and increase in quality of life.
  
  
  CONCLUSIONS
  When severe lower abdominal pain and bloating in women who have had pelvic surgery are reproduced by colonoscopy, and there is an obvious kink in the bowel, sigmoid colectomy is worth considering.
authors.affiliation: Department of Colorectal Surgery, Digestive Diseases Institute, Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH, 44143, USA.
authors.forename: Awad
authors.initials: A
authors.lastname: Jarrar
authors.forename: James
authors.initials: J
authors.lastname: Church
mesh_terms: D003082:Colectomy; D012809:Colon, Sigmoid / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D011795:Surveys and Questionnaires; D000267:Tissue Adhesions / Q000601:surgery