Jun Jiang1, Ning Li, Wei-ming Zhu, Jie-shou Li. 1. Department of General Surgery, Jinling Hospital, Nanjing University of Medical School, Nanjing 210002, China.
Abstract
OBJECTIVE: To explore the satisfactory surgical procedure for severe functional constipation (SFC). METHODS: The data of 50 SFC patients, undergone subtotal colectomy and modified Duhamel procedure from Sep. 2000 to Apr. 2005, were analyzed retrospectively. Gastrointestinal quality of life (GIQOL) of these patients were also evaluated. RESULTS: All the 50 patients failed to respond to conservative treatment and accepted subtotal colectomy and modified Duhamel procedure after finding pathological changes by the examination of colonoscopy, colon transit time (CTT) and dynamic proctography (DPG). Twenty-seven out of 50 cases (54%) showed colonic muscular atrophy and 29 out of 50 cases (58%) showed decreased ganglion cells in myenteric plexuses of colon. The mean follow-up time after surgical treatment was (2.4+/-1.2) years. GIQOL and constipation index improved dramatically after operations. Forty-four out of 50 patients (88%) were satisfied with their postoperative evacuation. Nine patients complained minor abdominal pain,3 patients diarrhea and 2 patients recurrence of constipation, who were healed by the use of bulk-forming laxatives and GI-mobility drugs. CONCLUSION: The combination of modified Duhamel procedure and subtotal colectomy is an effective surgical procedure for the treatment of SFC.
OBJECTIVE: To explore the satisfactory surgical procedure for severe functional constipation (SFC). METHODS: The data of 50 SFC patients, undergone subtotal colectomy and modified Duhamel procedure from Sep. 2000 to Apr. 2005, were analyzed retrospectively. Gastrointestinal quality of life (GIQOL) of these patients were also evaluated. RESULTS: All the 50 patients failed to respond to conservative treatment and accepted subtotal colectomy and modified Duhamel procedure after finding pathological changes by the examination of colonoscopy, colon transit time (CTT) and dynamic proctography (DPG). Twenty-seven out of 50 cases (54%) showed colonic muscular atrophy and 29 out of 50 cases (58%) showed decreased ganglion cells in myenteric plexuses of colon. The mean follow-up time after surgical treatment was (2.4+/-1.2) years. GIQOL and constipation index improved dramatically after operations. Forty-four out of 50 patients (88%) were satisfied with their postoperative evacuation. Nine patients complained minor abdominal pain,3 patientsdiarrhea and 2 patients recurrence of constipation, who were healed by the use of bulk-forming laxatives and GI-mobility drugs. CONCLUSION: The combination of modified Duhamel procedure and subtotal colectomy is an effective surgical procedure for the treatment of SFC.
Authors: Fan Li; Tao Fu; Weidong Tong; Anping Zhang; Chunxue Li; Yu Gao; Jin Song Wu; Baohua Liu Journal: Int J Colorectal Dis Date: 2014-09-25 Impact factor: 2.571