title: Late surgical complications of subtotal colectomy with antiperistaltic caeco-rectal anastomosis for slow transit constipation A critical analysis.
abstract: OBJECTIVE
  Despite a good percentage of success, mainly related to the amelioration of patient selection, surgery for slow transit constipation still presents failures and late complications, often unpredictable, and sometimes related to technical variants. The aim of the study is to critically analyze late surgical complications of subtotal colectomy with caeco-rectal anastomosis (SCCRA), examining the peculiar risks of the procedure and possible prevention measures.
  
  
  METHODS
  Follow-up data of 43 compliant patients submitted to SCCRA at our Institution were reviewed. Patients undergoing further surgery for a complication clearly related to SCCRA at our centre were included.
  
  
  RESULTS
  We identified three late surgical complications (7%): a caecal distension, an ileo-caecal volvulus and an ileal volvulus. all patients were successfully treated. an evident predisposing condition was found only in the first case.
  
  
  CONCLUSIONS
  Peculiar long term complications related to the presence of a dysfunctional or mobile caecal stump may be prevented by careful patient selection and surgical technique.
  
  
  BACKGROUND
  Constipation, Complication, Caecal distension, Ileo-caecal volvulus, Subtotal colectomy.
authors.forename: Federico
authors.initials: F
authors.lastname: Marchesi
authors.forename: Chiara
authors.initials: C
authors.lastname: Rapacchi
authors.forename: Stefano
authors.initials: S
authors.lastname: Cecchini
authors.forename: Leopoldo
authors.initials: L
authors.lastname: Sarli
authors.forename: Francesco
authors.initials: F
authors.lastname: Tartamella
authors.forename: Luigi
authors.initials: L
authors.lastname: Roncoroni
mesh_terms: D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D002429:Cecal Diseases / Q000209:etiology* / Q000601:surgery; D002432:Cecum / Q000601:surgery*; D003082:Colectomy / Q000379:methods*; D003248:Constipation / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005772:Gastrointestinal Transit; D006801:Humans; D007077:Ileal Diseases / Q000209:etiology* / Q000601:surgery; D045822:Intestinal Volvulus / Q000209:etiology* / Q000601:surgery; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D010528:Peristalsis; D011183:Postoperative Complications / Q000209:etiology*; D011446:Prospective Studies; D012007:Rectum / Q000601:surgery*; D012306:Risk