Retrospective series of side-to-side ileosigmoidostomy shunting surgery for the treatment of slow transit constipation in elderly patients

Abstract

Objective To evaluate the clinical and functional outcomes of Side-to-Side Ileosigmoidostomy Shunting Surgerys for the treatment of elder STC patients. Methods The clinical data of 67 patients all more than 63 years old with severe idiopathic STC treated with this novel approach between June 2010 and July 2017 were retrospectively analyzed. The perioperative complications and defection conditions were followed up by telephone and outpatient. The Wexner constipation score and gastrointestinal tract were compared before and after the operation. SPSS 19.0 software was used for statistical analysis. Independent sample t test was used for measurement data, t and χ2 test were used for comparison of count data. Results All the patients received their operations successfully without deaths or serious complication. The center follow-up period (from outpatients or phone) was 12 months (6-29 months). only 16 patients developed complications including 2 and 14 total colonic exclusion. 12 of the 14 got better obviously after enema and taken dynamic drugs, Only 2 patients with repeated abdominal pain and distention received jejunostomy. Six months after the operation, only 5 patients needed to take some drugs for defectation. Wexner constipation scores and Gastrointestinal Quality of Life Index (GIQLI) has improved obviously after 6 months and 12 months. Conclusions The novel surgical procedure, side-to-side ileosigmoidostomy Shunting Surgery that practised in our department, is an easy, safe and effective for the treatment of selected elderly patients with STC. Large-sample, randomized, controlled analyses are worth to investigate its clinical effects. Key words: Aged; Constipation; Treatment outcome; Slow-transit constipation; Elderly slow transit constipation patients; Total colonic exclusion and side to side ileorectal anastomosis; Wexner constipation scores; Gastrointestinal quality of life index