Outcome of colectomy for slow transit constipation

OBJECTIVE: To review the outcome data for colectomy performed for patients with slow transit constipation (STC). BACKGROUND: The outcome of surgical intervention in patients with STC is unpredictable. This may be a consequence of the lack of effectiveness of such interventions or may reflect heterogeneity within this group of patients. METHODS: The authors reviewed the data of all series in the English language that document the outcome of colectomy in > or = 10 patients in the treatment of STC. RESULTS: Thirty-two series fulfilled the entry criteria. There was widespread variability in patient satisfaction rates after colectomy (39% to 100%), reflecting large differences in the incidence of postoperative complications and in long-term functional results. Outcome was dependent on several clinical and pathophysiologic findings and on the type of study, the population studied, and the surgical procedure used. CONCLUSIONS: It may be possible to predict outcome on the basis of preoperative clinical and pathophysiologic findings. This review suggests a rationale for the selection of patients for colectomy.