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Surgical Outcomes after Total Colectomy with Ileorectal Anastomosis in Patients with Medically Intractable Slow Transit Constipation

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¼Õ±Í¿¬ ( Sohn Gui-Yun ) 
University of Ulsan College of Medicine Asan Medical Center Department of Colon and Rectal Surgery

À¯Ã¢½Ä ( Yu Chang-Sik ) 
University of Ulsan College of Medicine Asan Medical Center Department of Colon and Rectal Surgery
±èÂù¿í ( Kim Chan-Wook ) 
University of Ulsan College of Medicine Asan Medical Center Department of Colon and Rectal Surgery
°ûÀ翵 ( Kwak Jae-Young ) 
University of Ulsan College of Medicine Asan Medical Center Department of Colon and Rectal Surgery
ÀåÅ¿µ ( Jang Tae-Young ) 
University of Ulsan College of Medicine Asan Medical Center Department of Colon and Rectal Surgery
±è°æÈ£ ( Kim Kyung-Ho ) 
University of Ulsan College of Medicine Asan Medical Center Department of Colon and Rectal Surgery
¾ç¼º¼ö ( Yang Song-Soo ) 
University of Ulsan College of Medicine Asan Medical Center Department of Colon and Rectal Surgery
À±¿ë½Ä ( Yoon Yong-Sik ) 
University of Ulsan College of Medicine Asan Medical Center Department of Colon and Rectal Surgery
ÀÓ¼®º´ ( Lim Seok-Byung ) 
University of Ulsan College of Medicine Asan Medical Center Department of Colon and Rectal Surgery
±èÁøõ ( Kim Jin-Cheon ) 
University of Ulsan College of Medicine Asan Medical Center Department of Colon and Rectal Surgery

Abstract


Purpose: The aim of this study was to evaluate outcomes of a total colectomy with ileorectal anastomosis in patients with slow transit constipation.

Methods: A retrospective review of 37 consecutive patients with slow transit constipation who underwent a total colectomy between 1994 and 2008 was undertaken. Preoperative and postoperative Wexner¡¯s constipation scores were collected and used to evaluate the outcomes after surgical treatment. Also patients¡¯ postoperative satisfaction scores were collected using a 4-point scale.

Results: The 37 patients consisted of 31 women and 6 men, with a median age of 41 years (range, 17 to 71 years). Pre- and post-operative Wexner¡¯s scores were collected from 33 patients (89.1%), and the mean preoperative Wexner¡¯s score was 19.3 (range, 11 to 24), which decreased to an average post-operative score of 2.3 (range, 0 to 8). Neither intraoperative complications nor postoperative mortalities were noted. Five patients (13.5%) had early postoperative complications, and the most common complication was postoperative ileus (10.8%). Seven patients (18.9%) had late postoperative complications, and postoperative ileus (10.8%) was also the most common. Twenty seven of 33 patients were satisfied with their surgical outcome (81.8%).

Conclusion: A total colectomy with ileorectal anastomosis might be an effective surgical procedure with acceptable morbidity to treat medically intractable slow transit constipation.

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Colonic inertia;Colectomy;Treatment outcome;Postoperative complication

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