Abstract
BackgroundTo observe and compare the short term results and functional recovery of laparoscopic subtotal colectomy with antiperistaltic cecorectal anastomosis (LSCACRA) in the treatment of Adult slow transit constipation (STC) with two different reservoir length: short colonic reservoir and long colonic reservoir.MethodsAll STC patients treated with LSCACRA between April 2007 and December 2011 at our institution were followed up. Patients with 2 cm to 3 cm ascending colon preserved above the ileocecal junction were designated as observation group, whereas those preserved by 10 cm to 15 cm were classified as control group. 41 cases in the observation group and 40 cases in the control group were enrolled. Preoperative and outcome parameters of patients were collected, including gender, age, body mass index, operative time , blood loss, first flatus time, hospital stay, postoperative complications, Wexner constipation scale(WCS), Wexner incontinence scale, gastrointestinal quality of life index(GIQLI), abdominal pain intensity scale(APIS), abdominal pain frequency scale(APFS) and abdominal bloating scale(ABS).ResultsLaparoscopic surgeries were successfully carried out for all patients, without any case transferred to laparotomy or death related to surgery. The operative time, blood loss, first flatus time, and days of hospital stay of the two groups did not show significant differences. We found no significant differences on complications (Clavien–Dindo grade > I) between the two groups. No patient exhibited anastomotic leak. No fecal incontinence occurred in both groups. On the 3rd, 6th and 12th month after operation, the parameters of both groups significantly improved compared with the preoperative conditions (P < 0.05) except the APIS at 3rd and 6th month in control group. On the 3rd, 6th and 12th month after operation, the Functional Recovery outcomes of WCS、GIQLI、APIS、APFS and ABS in the observation group were superior to those in the control group (P < 0.05).ConclusionLSCACRA has a significant effect in the treatment of STC in adult. Postoperative outcomes can be optimized by shortening the length of the preserved ascending colon above the ileocecal junction, which promise better life quality of patients. Trial registration: Chinese Clinical Trial Registry ChiCTR-OPC-14005280, 2014-09-29.Electronic supplementary materialThe online version of this article (doi:10.1186/s12876-015-0257-7) contains supplementary material, which is available to authorized users.
Highlights
To observe and compare the short term results and functional recovery of laparoscopic subtotal colectomy with antiperistaltic cecorectal anastomosis (LSCACRA) in the treatment of Adult slow transit constipation (STC) with two different reservoir length: short colonic reservoir and long colonic reservoir
We evaluated functional recovery by collecting the data of bowel movement (BM), Wexner constipation scale (WCS), Wexner incontinence scale (WIS), gastrointestinal quality of life index (GIQLI), abdominal bloating scale (ABS), abdominal pain intensity scale(APIS) and abdominal pain frequency scale(APFS) before and every 3, 6, and 12 months after the operation
The two groups of patients suffered from a certain intensity of abdominal pain and abdominal bloating before the operation
Summary
To observe and compare the short term results and functional recovery of laparoscopic subtotal colectomy with antiperistaltic cecorectal anastomosis (LSCACRA) in the treatment of Adult slow transit constipation (STC) with two different reservoir length: short colonic reservoir and long colonic reservoir. Constipation is a common problem with 16% of women and 12% of men met the symptom criteria [1], which severely affects the life quality of patients. The surgical approach is currently the only way to treat long-term intractable slow transit constipation (STC) that is not responsive to pharmacological therapy. Constipation is relieved by increasing the frequency of bowel movement in the majority of patients after TC-IRA, some symptoms such as bloating, abdominal pain, intractable diarrhea, loss of nutrient substance and ileus are still common problems [4,5,6,7]. Surgeons are very careful with this choice
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
