Laparoscopically assisted subtotal colectomy with antiperistaltic cecorectal anastomosis.

Several trials have demonstrated the efficacy, low morbidity, and clinical benefit of laparoscopy, as compared with laparotomy, for the treatment of benign colorectal disease. Slow-transit constipation, also defined as colonic inertia (CI), improves after colectomy, and we recently proposed a technique for subtotal colectomy with a novel antiperistaltic cecorectal anastomosis (CRA). In this article, we propose a technique for subtotal colectomy with CRA via a laparoscopic approach. This technique was used to treat two young women affected by CI. The operating time was 320 and 360 min, respectively. There was no postoperative morbidity. The length of postoperative hospital stay was 10 days. One month after CRA, bowel frequency was regular in both cases. Our results allow us to state that laparoscopically assisted subtotal colectomy with CRA is safe and effective for patients with CI.