Subtotal colectomy with antiperistaltic cecoproctostomy for selected patients with slow transit constipation—from Chinese report

Jiang, Congqing; Qian, Qun; Liu, Zhisu; Bangoura, Gassimou; Zheng, Kaiyuan; Wu, Yunhua

doi:10.1007/s00384-008-0552-7

Cited by 35 publications

(39 citation statements)

References 21 publications

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“…Subtotal colectomy with antiperistaltic cecorectal anastomosis (SCCRA) seems to provide a valid alternative to total colectomy with ileorectal anastomosis (IRA), the most widely adopted procedure for slow-transit constipation, with potentially less functional impairment [5][6][7][8][9].…”

Section: Resultsmentioning

confidence: 99%

“…To some extent, SCCRA represented a first step in this direction: our previous report [7] and a more recent one [8] seem to point to an equal effectiveness and safety of the procedure compared with the more widely adopted and more invasive IRA, at lower rates of postoperative incontinence, resulting in potentially greater patient satisfaction and improvement in quality of life.…”

Section: Discussionmentioning

confidence: 99%

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Laparoscopic subtotal colectomy with antiperistaltic cecorectal anastomosis: a new step in the treatment of slow-transit constipation

et al. 2011

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Laparoscopic subtotal colectomy with antiperistaltic cecorectal anastomosis: a new step in the treatment of slow-transit constipation

et al. 2011

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“…Moreover, this procedure has the advantage of being widely applicable, as it is also a useful procedure for patients suffering from mixed constipation (in combination with mild obstruction defecation) [18] . On the other hand, total colectomy often leads to severe postoperative diarrhea and may seriously impair the patient's quality of daily life [9] . Intestinal obstruction and increased defecation frequency are common postoperative problems following surgery for STC [19] .…”

Section: Discussionmentioning

confidence: 99%

“…Patients suspected of STC were identified using the conventional criteria, including a consuming desire for defecation, significantly reduced intestinal motility, abdominal pain and bloating accompanied with mild agitation. The diagnosis of STC was established in accordance with the criteria established previously [9,10] and in agreement with the Rome III criteria [11] . These included repeated radiological examinations with results that were consistent with delayed colon transmission in the presence or the absence of mid-outlet obstruction, and with no other apparent pathological signs, as assessed by colonoscopic and anorectal manometry studies.…”

Section: Patient Selectionmentioning

confidence: 99%

Antiperistaltic Side-to-Side Ileorectal Anastomosis Is Associated with a Better Short-Term Fecal Continence and Quality of Life in Slow Transit Constipation Patients

Qian

et al. 2015

Dig Surg

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Background: Surgical treatment of refractory slow transit constipation (STC) is traditionally performed using end-to-side ileorectal anastomosis (SE-IRA) with total abdominal colectomy (TAC). Antiperistaltic side-to-side (SS) IRA is suggested to be a superior approach. Employing a well-characterized cohort of STC patients, we compared the postoperative outcomes of the 2 surgical approaches. Methods: A total of 42 patients underwent TAC for refractory idiopathic STC. Twenty patients were treated using traditional SE-IRA whereas 22 patients were treated using SS-IRA. Patients were evaluated at 3 and 6 months as well as at 1 and 2 years after surgery. Both groups were compared for patient characteristics, perioperative data and quality of life. Cleveland Clinic Incontinence Score (CCIS) and Gastrointestinal Quality of Life Index (GQILI) were adopted for evaluating postoperative recovery. Results: Both study groups were comparable with respect to general patient characteristics, disease severity and post-operative complications. Fewer than 30% of all patients reported substantial dissatisfaction with surgical outcomes in both the groups. The SS-IRA group was associated with a lower postoperative CCIS (p < 0.05) and a better GQILI (p < 0.05) than that of the SE-IRA group during early follow-up examinations. Conclusion: In this study, SS-IRA was superior to traditional SE-IRA for the treatment of STC with respect to post-operative outcomes, and especially during early follow-up.

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“…Zudem werden auch zunehmend retrospektive Analysen zur anisoperistaltischen caecorektalen Anastomose veröffentlicht [26][27][28]. Hier müssen jedoch die Langzeitergebnisse noch abgewartet werden.…”

Section: Antegrader Koloneinlaufunclassified

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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Subtotal colectomy with antiperistaltic cecoproctostomy for selected patients with slow transit constipation—from Chinese report

Abstract: Compared to the TAC-IRA, subtotal colectomy with end-to-end antiperistaltic cecoproctostomy for appropriately selected patients with STC resulted in relief of constipation, satisfactory functional outcome, and improved qualities of life.

Cited by 35 publications

References 21 publications

Laparoscopic subtotal colectomy with antiperistaltic cecorectal anastomosis: a new step in the treatment of slow-transit constipation

Laparoscopic subtotal colectomy with antiperistaltic cecorectal anastomosis: a new step in the treatment of slow-transit constipation

Antiperistaltic Side-to-Side Ileorectal Anastomosis Is Associated with a Better Short-Term Fecal Continence and Quality of Life in Slow Transit Constipation Patients

Indikationen und Therapieoptionen aus chirurgischer Sicht bei der Kolontransitstörung

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