Laparoscopic total colectomy for colonic inertia: surgical and functional results
| Autor: | Álvaro Zúñiga, Alejandro J. Zarate, Eduardo A. Garcia, María Elena Molina, Francisco López, George Pinedo |
|---|---|
| Rok vydání: | 2008 |
| Předmět: |
Adult
medicine.medical_specialty Constipation Adolescent medicine.medical_treatment Cohort Studies Young Adult Ileum Humans Medicine Defecography Colectomy Retrospective Studies Barium enema Rectal hemorrhage Chronic constipation medicine.diagnostic_test business.industry Anastomosis Surgical Anorectal manometry Rectum Recovery of Function Middle Aged medicine.disease Surgery Treatment Outcome Chronic Disease Female Laparoscopy medicine.symptom business Abdominal surgery |
| Zdroj: | Surgical Endoscopy. 23:62-65 |
| ISSN: | 1432-2218 0930-2794 |
| DOI: | 10.1007/s00464-008-9901-4 |
| Popis: | Total colectomy is the surgery of choice for colonic inertia (CI) when medical treatment has failed. Laparoscopic total colectomy has demonstrated to be a feasible technique. Present our experience in patients with CI who underwent laparoscopic total colectomy (TC) + ileorectoanastomosis (IRA) and evaluate the functional results and medium-term follow-up after this surgery. All patients with CI were included in a prospective laparoscopic surgical protocol, from 2002 to 2007. These patients had a complete work-up for chronic constipation (clinical records, barium enema, colonic transit time, defecography, anorectal manometry, small bowel follow through). All patients were evaluated with Wexner’s score for constipation pre- and postoperatively, asked if they would recommend surgery to other patients, and if they were satisfied with the procedure (on a scale from 1 to 10). Statistical analysis was carried out using Student’s T-test. In this period 20 patients were operated with diagnosis of CI. All patients were females with an average age of 41.5 years (range 18–52 years). Mean operative time was 248 min (range 170–360 min). One (5%) patient was converted to open surgery. The medium time to flatus per anum and feeding was 2 (range 1–6) and 3 (range 2–6) days, respectively. The medium postoperative stay was 7 days. Seven patients (35%) presented surgical postoperative complications (three postoperative ileus, one portal thrombosis, one rectal hemorrhage, one anastomotic leakage, and one hemoperitoneum). There was no postoperative mortality. The average follow-up was 25 months (range 1–60 months). Preoperative Wexner’s constipation score was 22.3 (range 19–29 months) pre surgery and at the end of follow-up was 1.8 (range 0–6) (p |
| Databáze: | OpenAIRE |
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