Long-Term Response to Subtotal Colectomy in Colonic Inertia

The purpose of this study was to determine the long-term outcome of patients who had previously undergone subtotal colectomy for severe idiopathic constipation at the University of Florida between 1983 and 1987. In addition, we aimed to determine whether preoperative motility abnormalities of the up...

Full description

Saved in:
Bibliographic Details
Published in:Journal of gastrointestinal surgery 2002-09, Vol.6 (5), p.738-744
Main Authors: Verne, G.Nicholas, Hocking, M.P, Davis, R.H, Howard, R.J, Sabetai, M.M, Mathias, J.R, Schuffler, M.D, Sninsky, C.A
Format: Article
Language:English
Subjects:
Adolescent
Adult
Child
colectomy
Colectomy - methods
Colleges & universities
Colon - pathology
Colonic Diseases, Functional - surgery
colonic inertia
Constipation
Constipation - surgery
Excretory system
Female
Follow-Up Studies
Gastrointestinal Motility
Humans
Inertia
Middle Aged
Motility
myenteric plexus
Pain
Pain Measurement
Reoperation
Retrospective Studies
small bowel motility
Time Factors
Treatment Outcome
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:The purpose of this study was to determine the long-term outcome of patients who had previously undergone subtotal colectomy for severe idiopathic constipation at the University of Florida between 1983 and 1987. In addition, we aimed to determine whether preoperative motility abnormalities of the upper gastrointestinal tract are more common among those patients who have significant postoperative complications after subtotal colectomy. We evaluated 13 patients who underwent subtotal colectomy for refractory constipation between 1983 and 1987 at the University of Florida. Preoperatively, all patients exhibited a pattern consistent with colonic inertia as demonstrated by means of radiopaque markers. Each patient was asked to quantitate the pain intensity and frequency of their bowel movements before and after surgery. In seven patients an ileosigmoid anastomosis was performed, whereas in six patients an ileorectal anastomosis was used. Abdominal pain decreased after subtotal colectomy. Patients with abnormal upper gastrointestinal motility preoperatively experienced greater postoperative pain than those with normal motility regardless of the type of anastomosis. In addition, the number of postoperative surgeries was similar in those patients with abnormal upper motility compared to those with normal motility. Overall, the total number of bowel movements per week increased from 0.5 ± 0.03 preoperatively to 15 ± 4.5 ( P < 0.007) postoperatively. The results of our study suggest that patients with isolated colonic inertia have a better long-term outcome from subtotal colectomy than patients with additional upper gastrointestinal motility abnormalities associated with their colonic inertia. ( J Gastrointest Surg 2002;6:738–744)
ISSN:1091-255X
1873-4626
DOI:10.1016/S1091-255X(02)00022-7