Korean J Gastrointest Motil.  2001 Nov;7(2):204-215.

Clinical Features and Functional Outcome of the Patients with Idiopathic Chronic Constipation Who Underwent Surgical Treatment

Affiliations
  • 1Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. hjson@smc.samsung.co.kr
  • 2Department of General Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Abstract

BACKGROUND: In patients with intractable constipation who are poorly responsive to medical treatments, surgical treatments may be considered. However, how preoperative physiologic evaluations contribute to some information in making surgical decision is not established. The aim of this study was to evaluate the outcome of surgical treatment in patients with severe constipation who underwent preoperative functional study.
METHODS
Preoperative functional evaluation included colon transit time test, defecography, scintigraphic gastric emptying time test, anorectal manometry and balloon expulsion test. Nine patients with a mean age of 48 years old were taken total colectomy with ileorectal anastomosis. Slow colonic transit was demonstrated in each case. All patients were available for follow-up, with median time of 35 (range; 10-55) months.
RESULTS
Seven patients (78%) were satisfied with outcome, improved the quality of life, and felt the operation was valuable despite of residual symptoms. Two patients did not experience symptom improvements. Six of seven colonic inertia or combined spastic pelvic floor syndrome patients had a satisfactory outcome. In contrast, one of two patients with generalized intestinal dysmotility did not show any improvement after surgery.
CONCLUSIONS
Preoperative physiologic testing reliably identified patients with severe constipation who might have benefits from surgery. If cases are carefully diagnosed and selected, the surgical treatment may be highly effective in alleviating symptoms.

Keyword

Constipation; Colectomy

MeSH Terms

Colectomy
Colon
Constipation*
Defecography
Follow-Up Studies
Gastric Emptying
Humans
Manometry
Middle Aged
Muscle Spasticity
Pelvic Floor
Quality of Life
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