Surgery for constipation

Pfeifer, Johann; Agachan, Feran; Wexner, Steven D.

doi:10.1007/bf02054062

Cited by 114 publications

(67 citation statements)

References 124 publications

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“…Constipation can be caused by colonic disorders such as colonic inertia, sigmoidocele and rectal prolapse [9][10][11][12]. Since surgery for constipation was first performed by Lane [13], it has become widely accepted [8,[14][15][16][17].…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic-assisted surgery for constipation

Alabaz

Nessim

Iroatulam

et al. 1999

Techniques in Coloproctology

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The aim of this study was to evaluate the safety, outcome and disability of various forms of laparoscopicassisted colectomy for constipation. Between August 1991 and February 1995, 14 patients with constipation who underwent laparoscopic assisted total abdominal colectomy with ileorectal anastomosis (TAC + IR) or sigmoidectomy with colorectal anastomosis (SC + CR) with or without rectopexy were analyzed. Parameters included age, sex, preoperative medical treatment and evaluation, constipation score, indication for surgery, procedure performed, length of surgery, postoperative ileus, and hospitalization as well as morbidity, cosmesis, functional outcome and return to partial and full activity. Surgery was undertaken for colonic inertia (6 patients) and obstructing sigmoidocele with or without prolapse (8 patients) in 12 females and 2 males with a mean age of 47.5 (range 22-77) years. The mean history of laxative-or enema-dependent constipation was 18.3 (range 7-35) years and the mean constipation score was 24.4 (range 20-29). The overall mean operating time was 217.5 (range 125-325) min; 260 (range 195-315) min in the patients with TAC + IR, and 185.6 (range 125-325) min in the patients with SC + CR with or without rectopexy (P < 0.05). The mean length of postoperative ileus was 3.8 (range 2-7) days, and the length of hospitalization was 7.6 (range 4-15) days. There were 3 (21%) cases of intraoperative complications, and 4 cases of (29%) postoperative complications. At a mean follow-up of 37.8 (range 18-60) months, the mean frequency of bowel movements had increased from 2.5 per week preoperatively to 8.4 per week postoperatively (P < 0.0001). Ten patients reported excellent or good results relative to cosmesis. The mean time to return to partial activity was 1.7 (range 1-3) weeks, and return to full activity was 5.1 (range 3-10) weeks. Although laparoscopic procedures for constipation have definite advantages including better cosmesis and more rapid return to partial and full activity, disadvantages include the long operating time that may preclude its routine application.

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Section: Introductionmentioning

confidence: 99%

Laparoscopic-assisted surgery for constipation

Alabaz

Nessim

Iroatulam

et al. 1999

Techniques in Coloproctology

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“…All of the patients had an uneventful postoperative course and were discharged from hospital within 10-18 days (mean 11.4 days). The prolonged hospital stay of three cases (16,17, and 18 days, respectively) was for the management of postoperative frequent bowel movements.…”

Section: Resultsmentioning

confidence: 98%

“…This fact is extremely important, since the procedure to which subtotal colectomy with CRA is an alternative is total colectomy with ileorectal anastomosis, which is marked by a high rate of small bowel occlusion. 8,11,16 It has been hypothesized that the mobility of ileorectal anastomosis favors its torsion and that the amply deperitonized pelvic zone is the cause of adhesions in the loops of the small bowel. 8 Conversely, subtotal colectomy with CRA allows for conservation of the normal anatomic proportions of the ileocolonic junction and the filling in of the pelvis with the cecum, thus preventing adhesions in the loops of the small bowel.…”

Section: Discussionmentioning

confidence: 99%

“…14,15 Theoretically, there are advantages in sparing the ileocecal junction and cecum after removal of the remaining part of the colon; however, these advantages do not always prevail in clinical practice 9 and, for diseases such as chronic constipation, some surgeons prefer to perform ileorectostomy. 16 To determine the clinical role and the postoperative results of CRA, we reviewed our experience of performing this operation.…”

Section: Introductionmentioning

confidence: 99%

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Long-Term Results of Subtotal Colectomy with Antiperistaltic Cecoproctostomy

et al. 2003

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“…1,12 In patients with a segmental disease such as sigmoid megacolon, a limited resection has good results. 13 A more extensive resection such as a subtotal colectomy with ileorectal anastomosis may be required only when there is total colonic inertia. Ideally, before resection the proximal colon if fecally loaded should be cleared by PEG or on table by a colonic lavage.…”

mentioning

confidence: 99%