Functional outcomes and quality of life in patients treated with laparoscopic total colectomy for colonic inertia

• Published in: Surgery today (Tokyo, Japan) Japan), 2014, Vol.44 (1), p.34-38
• Main Authors: Vergara-Fernandez, Omar, Mejía-Ovalle, Rabí, Salgado-Nesme, Noel, Rodríguez-Dennen, Nathalie, Pérez-Aguirre, Javier, Guerrero-Guerrero, Víctor Hugo, Sánchez-Robles, Juan Carlos, Valdovinos-Díaz, Miguel Angel
• Format: Article
• Language: English
• Subjects: Adult; Anastomotic Leak - epidemiology; Anastomotic Leak - etiology; Colectomy - adverse effects; Colectomy - methods; Constipation - physiopathology; Constipation - surgery; Defecation; Female; Follow-Up Studies; Gastrointestinal Motility; Humans; Laparoscopy - adverse effects; Laparoscopy - methods; Male; Medicine; Medicine & Public Health; Middle Aged; Original Article; Quality of Life; Surgery; Surgical Oncology; Surveys and Questionnaires; Treatment Outcome; Young Adult
• ISSN: 0941-1291; 1436-2813
• DOI: 10.1007/s00595-012-0464-6

Purpose To assess the functional outcomes and quality of life in patients with laparoscopic total colectomy for slow-transit constipation (STC). Methods All patients undergoing laparoscopic colectomy with ileorectal anastomosis for colonic inertia at two referral centers were analyzed. Their preoperative, intraoperative and postoperative details were recorded with a one-year follow-up. Their quality of life was assessed using the SF-36 questionnaire. Results Between 2004 and 2007, 710 patients were evaluated. Eight female patients (1.1 %) fulfilled the criteria for STC without obstructive defecation syndrome. Their mean age was 38 years ± 15 (range from 22 to 62). The conversion rate was 12.5 %. The morbidity rate was 37.5 %, and mortality was nil. The preoperative abdominal pain was 6.6 ± 0.3 and had decreased to 3.6 ± 2.3 postoperatively ( P  = 0.008). At 1 year, the defecation frequency per week had increased from 0.84 ± 0.24 to 6.75 ± 3.4 ( P  = 0.001). Three patients developed nocturnal leakage (37.5 %). Eighty-eight percent of the patients recommend the procedure. All parameters of the SF-36 questionnaire had improved at the one-year follow-up examination. Conclusion Laparoscopic colectomy for slow-transit constipation is safe and increased the number of evacuations per week. Although nocturnal leakage may occur, these patients experience improvements in their quality of life.