Subtotal colectomy for severe idiopathic constipation

Leon, Samuel H.; Krishnamurthy, Shoba; Schuffler, Michael D.

doi:10.1007/bf01296374

Cited by 66 publications

(22 citation statements)

References 10 publications

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“…Similar conclusions have been drawn by Waldron et al [40] in their severe constipation patients. Since these pa tients often undergo subtotal colectomy and ileorectal anastomosis for relief of their symptoms [49][50][51], the abnormal rectal function might be responsible for the ad verse outcome reported in a considerable number of subjects [50,51].…”

Section: Discussionmentioning

confidence: 99%

Prolonged (24-Hour) Manometric Recording of Rectal Contractile Activity in Patients with Slow Transit Constipation

Bassotti

Betti²,

Pelli³

et al. 1991

Digestion

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A periodic motor activity, named the rectal motor complex, has been recently described in the healthy human rectum. We studied the rectal contractile activity for 24 h by a low compliance manometric system in a group of 10 women with slow transit constipation. Analysis of the 24-hour manometric recordings showed that these subjects: (1) had overall scarce rectal motility; (2) display few rectal motor complexes (average, 3.3 ± 1.3/subject/24 h) which are irregularly distributed over time, and (3) respond weakly to ingestion of a standard meal (average duration of the motor response 19 ± 6 min). The observations suggest that an underlying neuropathic process may be involved in the pathogenesis of the impaired rectal motility in patients with slow transit constipation.

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Section: Discussionmentioning

confidence: 99%

Prolonged (24-Hour) Manometric Recording of Rectal Contractile Activity in Patients with Slow Transit Constipation

Bassotti

Betti²,

Pelli³

et al. 1991

Digestion

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“…Although most cases of constipation respond to simple therapeutic measures, in a minority of cases constipation is defined as intractable and needs a more aggressive therapeutic approach, such as surgery [5]. However, this extreme approach should be regarded with caution, since the reported success rate varies from 50 to 100% [6, 7, 8], although the higher success rate is probably due to the shorter length of follow-up. In fact, a recent examination of 11 series of surgery for intractable constipation disclosed that the average success rate approached 99% in series with a mean follow-up of 2 years or less, whereas it was only about 60% in those with a mean follow-up of more than 2 years [9].…”

Section: Introductionmentioning

confidence: 99%

Endoluminal Instillation of Bisacodyl inPatients with Severe (Slow Transit Type)Constipation Is Useful to Test Residual ColonicPropulsive Activity

Bassotti

Chiarioni²,

Germani

et al. 1999

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Background: Chronic constipation is a frequent symptom among the general population, and a minority of cases do not respond to any therapeutic measures, except surgery. The purpose of this study was to test the residual colonic motor propulsive activity with a pharmacologic stimulus in a series of patients referred for severe constipation. Patients: Twenty-five chronically constipated patients, slow transit type, age range 16–71 years, unresponsive to conventional medical treatment and referred for functional evaluation, entered the study. Methods: Colonic manometry by means of an endoscopically positioned probe was carried out in all patients. Following a basal recording period, a placebo solution followed by 10 mg bisacodyl solution was infused into the colon through the more proximal recording port. Results: After bisacodyl infusion, about 90% of patients showed a motor response characterized by the appearance (within on average 13 ± 3 min) of one or more high-amplitude propagated contractions, the manometric equivalent of mass movements, and about 75% of these were followed (mean 18.5 ± 4 min) by defecation. Conclusions: Physiological and pharmacological testing of colonic motor activity may be important in severely constipated patients, especially in those labeled as ‘intractable’, in whom more in depth investigation planning may encourage further therapeutic efforts.

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“…Preston et al [48] 1984 38 14 Leon et al [28] 1987 31 31 Kamm et al [19] 1988 8 2 Vasilevsky et al [63] 1988 …”

Section: Autormentioning

confidence: 98%

Die schwere idiopathische Obstipation Pathophysiologie, Diagnose und Therapie

Sailer

Debus²,

Kraemer³

et al. 1998

Coloproctol

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Zusammenfassung: Bei der schweren idiopathischen Obstipation (sogenannte ,,stow transit constipation") handelt es sich um eine seltene Erkrankung, die fast ausschlieglich bei Frauen in der dritten und vierten Lebensdekade angetroffen wird. Pathophysiologie und Jktiologie dieser Erkrankung sind nur zum Teil bekannt, wobei es sich h6chstwahrscheinlich um ein multifaktorielles Geschehen handelt. Abstract: Slow transit constipation is a rare condition almost exclusively encountered in middle-aged women. Pathophysiology and aetiology are poorly understood but a multi-factorial pathogenesis seems likely. With regard to differential diagnoses mechanical, drug induced, degenerative, metabolic, endocrinologic, neurologic and psychiatric causes of constipation must be excluded by an interdisciplinary approach. Gastrointestinal physiologic investigations including measurement of colonic transit ate mandatory. Furthermore, pangastrointestinal transit delay, pelvic floor dysfunction (outlet obstruction) and irritable bowel syndrome should be excluded. The initial mode of treatment is st¡ conservative. In cases of progression or persistence of symptoms surgical therapy should be offered. Subtotal co[ectomy with ileorectal anastomosis can be regarded as the standard operation for slow transit constipation. Postoperative complications include smal! bowel obstruc~Chirurgische Klinik und Poliklinik der Universit~it Wª (Direktor: Prof. Dr. A. Thiede).

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Subtotal colectomy for severe idiopathic constipation

Cited by 66 publications

References 10 publications

Prolonged (24-Hour) Manometric Recording of Rectal Contractile Activity in Patients with Slow Transit Constipation

Prolonged (24-Hour) Manometric Recording of Rectal Contractile Activity in Patients with Slow Transit Constipation

Endoluminal Instillation of Bisacodyl inPatients with Severe (Slow Transit Type)Constipation Is Useful to Test Residual ColonicPropulsive Activity

Die schwere idiopathische Obstipation Pathophysiologie, Diagnose und Therapie

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