Hand-assisted laparoscopic total colectomy for slow transit constipation

Hsiao, Kevin C. W.; Jao, Shu-Wen; Wu, Chang‐Chieh; Lee, Tsai‐Yu; Lai, Huang-Jen; Kang, Jung-Cheng

doi:10.1007/s00384-007-0431-7

Cited by 45 publications

(44 citation statements)

References 20 publications

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“…Our data shows that this operation is feasible and safe with no mortality and acceptable morbidity, as reported in previous studies [3][4][5][6][7][8][9][10][11] (Table 5). The early postoperative results highlight problems with bowel function after total colectomy with a mean of 4.4 d until the first bowel movement.…”

Section: Discussionsupporting

confidence: 69%

“…For selected patients presenting with mild disease in the rectum, no dysplasia and with normal rectal compliance, a subtotal colectomy with ileo-distal sigmoid anastomosis may be an alternative and was performed in this study. Few published reports exist and mainly report techniques performed for a single indication or include small numbers of patients [3][4][5][6][7][8][9][10] . The aim of this study was to report the outcomes of laparoscopic total colectomy based on indication, comparing IBD with other indications.…”

Section: Introductionmentioning

confidence: 99%

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Laparoscopic total colectomy: Does the indication influence the outcome?

Cotte

Mohamed²,

Nancey³

et al. 2011

WJGS

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AIM:To assess and compare outcomes of laparoscopic total colectomy performed for a variety of indications. METHODS:Sixty six patients underwent laparoscopic total colectomy for inflammatory bowel disease (IBD) (13) and other diseases (53). Data on demographics, pre-and post-operative outcomes were collected prospectively. RESULTS:Mean operative time was 4.5 h. Conversion rate was 13.6%. Total colectomy performed for IBD was associated with a significantly higher anastomotic leak rate (23.1% vs 1.9%, P < 0.05). On univariate analysis, hand sewn anastomosis and treatment with more than 20 mg of prednisolone for at least 3 mo was associated with a higher anastomotic leak rate (P < 0.05). No significant difference was found in return of gut function and overall morbidity between disease groups. CONCLUSION:Laparoscopic total colectomy is feasible and outcomes are equivalent whatever the indication, except for anastomotic leak rate which is higher for patients with IBD.

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Section: Discussionsupporting

confidence: 69%

Section: Introductionmentioning

confidence: 99%

Laparoscopic total colectomy: Does the indication influence the outcome?

Cotte

Mohamed²,

Nancey³

et al. 2011

WJGS

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“…The most common clinical features include refractory constipation, abdominal pain, abdominal distension, and nausea. Necessary physiological examinations include colonic transit test, colonoscopy, anal manometry, defecography, and balloon expulsion [7,8]. In this study, all eligible patients showed positive results in colonic transit test, but the colonoscopy, defecography, manometry, and balloon expulsion showed to be normal.…”

Section: Discussionmentioning

confidence: 76%

“…Pathologically, this disease may be caused by enteric neuropathy resulting from abnormality of the enteric nervous system. Several studies revealed that this abnormality was considered to be related to a decrease in the interstitial cell of Cajal, which was recognized as an intestinal pacemaker and mainly situated in the submucosal and myenteric plexus of the bowel wall [2,7,9]. On the contrary, Toman et al [10] demonstrated that the decreased numbers of interstitial cells of Cajal did not significantly contribute to colonic inertia.…”

Section: Discussionmentioning

confidence: 99%

The role of hand-assisted laparoscopic surgery in total colectomy for colonic inertia: a retrospective study

Wang

Lin

et al. 2013

J Korean Surg Soc

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PurposeTo compare and assess the efficacy, safety and utility of hand-assisted laparoscopic surgery (HALS) with open surgery (OS) in total colectomy with ileorectal for colonic inertia.MethodsFrom January 2001 to February 2012, 56 patients diagnosed with colonic inertia who failed to respond to medical treatments underwent hand-assisted laparoscopic total colectomy with ileorectal anastomosis. Another 68 patients underwent laparotomy. Main parameters such as clinical manifestations, conversion to open procedure, operative time, incision length, pain score, intraoperative blood loss, time to first flatus and hospitalization, early postoperative complications and hospitalization cost were retrospectively analyzed. Postoperative defecating frequencies were followed up in both groups.ResultsAll patients received successful operation, no surgical mortality happened and none of the patients required conversion to an exploratory laparotomy in HALS group. The clinical features, the estimated blood loss, incision length, pain score, first passing flatus time, and postoperative hospitalization time were superior in HALS group (P < 0.05). The early postoperative complications and frequency of defecation were similar. However, the mean operative time was longer and hospitalization cost was higher in HALS group than those in OS group (P < 0.05).ConclusionHALS total colectomy can be a safe and efficient technique in the treatment of colonic inertia. HALS can result in a better cosmetic result and a quicker postoperative recovery, but requires higher direct cost.

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“…Die generellen Vorteile der laparoskopischen Kolonchirurgie kommen auch hier zum Tragen; insbesondere die niedrigeren Raten an postoperativen Verwachsungen sowie die schnellere Rekonvaleszenz der Patienten stehen hierbei im Vordergrund [33][34][35].…”

Section: Laparoskopische Kolektomieunclassified

Indikationen und Therapieoptionen aus chirurgischer Sicht bei der Kolontransitstörung

Zehler¹,

Kutup²

2012

Viszeralmedizin

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Hintergrund: Die Therapie der schweren Obstipation bedingt durch eine gestörte Kolontransitstörung stellt eine interdisziplinäre Herausforderung dar. Seit Beginn des letzten Jahrhunderts wurden zu diesem Krankheitsbild verschiedene chirurgische Therapieansätze evaluiert. Methoden: Zu den operativen Verfahren gehören die erweiterte Hemikolektomie links mit caecorektaler Anastomose, die subtotale Kolektomie mit ileosigmoidaler Anastomose und die totale Kolektomie mit ileorektaler Anastomose. Ergebnisse: Seit 1981 wurden mehrere Studien veröffentlicht, die sich mit der chirurgischen Therapiemöglichkeit dieser Erkrankung beschäftigen. Die unmittelbare post-operative Patientenzufriedenheit ist insgesamt hoch und liegt bei 82%. Jedoch besteht bei 41% der Patienten eine erhöhte Inzidenz an postoperativen Früh- und Spätkomplikationen (Inkontinenz, Diarrhö, Obstipationsrezidiv, Ileus, Schmerzen). Die Ergebnisse der Langzeituntersuchungen zeigen zudem eine Abnahme der Patientenzufriedenheit. Schlussfolgerung: Als Standardoperation bei der Passagestörung («slow transit constipation», STC) hat sich die totale Kolektomie mit ileorektaler Anastomose durchgesetzt. Bei Versagen der konservativen Therapie ist bei einer STC für ein selektioniertes Patientenkollektiv die totale Kolektomie die Therapieoption der Wahl. Eine umfangreiche präoperative Diagnostik muss vor einer chirurgischen Therapie erfolgen. Die präoperative Diagnostik beinhaltet neben einer ausführlichen symptombezogenen Anamnese die koloproktologischen Basisuntersuchungen, die Kolontransitzeitbestimmung, die Defäkographie und die Analmanometrie. Eine psychologische Evaluation der Patienten ist essenziell, da sich dieser Faktor negativ auf das postoperative Outcome auswirken kann.

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Hand-assisted laparoscopic total colectomy for slow transit constipation

Abstract: Hand-assisted laparoscopic total colectomy could be a safe and efficient technique in the treatment of STC.

Cited by 45 publications

References 20 publications

Laparoscopic total colectomy: Does the indication influence the outcome?

Laparoscopic total colectomy: Does the indication influence the outcome?

The role of hand-assisted laparoscopic surgery in total colectomy for colonic inertia: a retrospective study

Indikationen und Therapieoptionen aus chirurgischer Sicht bei der Kolontransitstörung

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