Subtotal Colectomy with Antiperistaltic Cecorectal Anastomosis in the Treatment of Slow-transit Constipation: Long-term Impact on Quality of Life |
| |
Authors: | Federico Marchesi Leopoldo Sarli Luigi Percalli Giuliano Ezio Sansebastiano Licia Veronesi Davide Di Mauro Cristina Porrini Michelina Ferro Luigi Roncoroni |
| |
Institution: | (1) Department of Surgical Sciences, Section of General Surgical Clinics and Surgical Therapy, Parma University Medical School, Parma, Italy;(2) Department of Public Health, Section of Hygiene, Parma University Medical School, Via Gramsci n.14, 43100 Parma, Italy;(3) Department of Surgery Section of Anesthesiology, Intensive Care and Pain Therapy Parma Hospital, Via Gramsci n.14, 43100 Parma, Italy |
| |
Abstract: | Background The aim of the study was to evaluate the effectiveness of subtotal colectomy with cecorectal anastomosis (SCCA) in the treatment
of slow-transit constipation, not just in terms of symptom resolution but also the overall impact on patients’ quality of
life.
Methods Between 1991 and 2005, 43 patients underwent SCCA at our institution, 22 for slow-transit constipation (STC) and 21 for other
types of colic diffuse disease (non-slow-transit constipation: NSTC), the latter being considered controls. A total of 29
patients (17 affected by STC) were administered a 50-item telephonic questionnaire, including the Gastrointestinal Quality
of Life Index (GIQLI), the Wexner constipation and incontinence scale (WC, WI), and individual willingness to repeat the procedure.
Questionnaire data and other parameters such as age, sex, length of follow-up, complications, and length of hospital stay
were analyzed and compared, in order to evaluate possible correlations between the parameters and their related impact on
quality of life, procedural effectiveness in terms of symptomatic regression, qualitative differences related to pathology
(constipation versus non-constipation), and surgical approach (laparotomy versus video-laparo-assisted procedure).
Results There were no procedure-related deaths in this series (mortality: 0%); however, we found two complications in the STC group
(9.1%), one requiring reoperation. The GIQLI mean score for the STC group was 115.5 ± 20.5 (mean score for healthy people
125.8 ± 13), and the WC mean score passed from a preoperative value of 20.3 to a postoperative value of 2.6. Regression analysis
revealed a significant correlation between GIQLI and urgency and abdominal pain, and abdominal pain correlated significantly
with pathology (STC). A high number of patients (88.2% in STC) expressed a willingness to repeat the procedure given the same
preoperative conditions.
Conclusions Comparing our results to those of the most homogeneous literature data, SCCA does not appear to be inferior to subtotal colectomy
with ileorectal anastomosis (IRA) in terms of therapeutic effectiveness, postoperative mortality and morbidity, or overall
impact on quality of life. |
| |
Keywords: | |
本文献已被 PubMed SpringerLink 等数据库收录! |
|