Laparoscopically assisted subtotal colectomy with ileorectal anastomosis for slow transit constipation

Abstract

<b>Introduction</b>: The aim of this study was to retrospectively review the surgical outcomes of laparoscopically assisted subtotal colectomy with ileorectal anastomosis, in order to evaluate the feasibility, utility, and functional outcomes of this procedure in patients with slow transit constipation.<br /> <b>Material and methods: </b> The analysis included patients treated between January 2012 and January 2015. Slow transit constipation was diagnosed following a colonic transit test, anal manometry test, balloon expulsion test, and barium enema to exclude secondary causes. Patients deemed suitable underwent laparoscopically assisted total colectomy with ileorectal anastomosis. The main outcome measures included the operative time, estimated blood loss, time to first flatus, length of hospital stay, and complications.<br /> <b>Results: </b> Ten female patients (mean age: 36.9 years) underwent laparoscopically assisted subtotal colectomy with ileorectal anastomosis for slow transit constipation. The mean operative time was 133 min, while the mean length of the largest incision was 4.2 cm, and the mean estimated blood loss was 90 ml. The mean time to first flatus was 2.4 days, and the mean duration of hospital stay was 7.6 days. No conversion to laparotomy was noted (0%). Post-operative complications included one wound infection and one ileus. There was no mortality associated with the procedure, and 9 (90%) patients expressed excellent or good satisfaction regarding the outcomes.<br /> <b>Conclusions</b>: Laparoscopically assisted subtotal colectomy with ileorectal anastomosis is well tolerated, and careful patient selection results in excellent outcomes, with improvement in bowel function. Laparoscopic techniques may represent a safe and efficient option to manage slow transit constipation.