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Long-term results of subtotal colectomy with cecorectal anastomosis for isolated colonic inertia

World Journal of Gastroenterology 2007年第18期13卷 2590-2595页

作者： Antonio Iannelli Thierry Piche Raffaella Dainese Pascal Fabiani Albert Tran jean mouiel jean Gugenheim Service de Chirurgie Digestive-Université de Nice-Sophia-Antipolis Faculté de Médecine Nice F-06107 France & Centre Hospitalier Universitaire de Nice Ple Digestif Nice F-06107 France Service de Gastroentérologie-Université de Nice-Sophia-Antipolis Faculté de Médecine Nice F-06107 France & Centre Hospitalier Universitaire de Nice Ple Digestif Nice F-06107 France Inserm U526 Nice F-06107 France Service de Gastroentérologie-Université de Nice-Sophia-Antipolis Faculté de Médecine Nice F-06107 France & Centre Hospitalier Universitaire de Nice Ple Digestif Nice F-06107 France

AIM： To evaluate the results of sub total colectomy withI cecorectal anastomosis （STC-CRA） for isolated colonicinertia （CI）. METHODS： Fourteen patients （mean age 57.5±16.5 year） underwent surgery for isolated CI between January 1986 and December 2002. The mean frequency of bowel motions with the aid of laxatives was 1.2±0.6 per week. All subjects underwent colonoscopy, anorectal manometry, cinedefaecography and colonic transit time （CTF）. CI was defined as diffuse markers delay on CTF without evidence of pelvic floor dysfunction. All patients underwent STC-CRA. Long-term follow-up was obtained prospectively by clinical visits between October 2005 and February 2006 at a mean of 10.5 ＋ 3.6 years （range 5-16 years） during which we considered the number of stool emissions, the presence of abdominal pain or digitations, the use of pain killers, laxatives and/or fibers. Patients were also asked if they were satisfied with the surgery. RESULTS： There was no postoperative mortality Postoperative complications occurred in 21.4% （3/14）. At the end of follow-up, bowel frequency was significantly （P〈0.05）increased to a mean of 4.8±7.5 per day （range 1-30）. One patient reported disabling diarrhea. Two patients used laxatives less than three times per month without complaining of what they called constipation Overall, 78.5% of patients would have chosen surgery again if necessary. CONCLUSION： STC-CRA is feasible and safe in patients with CI achieving 79% of success at a mean follow-up of 10.5 years. A prospective controlled evaluation is warranted to verify the advantages of this surgical approach in patients with CI.

关键词： Constipation Colonic inertia Surgery Subtotal colectomy Cecorectal anastomosis

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