Top

Published in:

14-03-2023 | Constipation | Original Article

Laparoscopic total colectomy with ileorectal anastomosis and subtotal colectomy with antiperistaltic cecorectal anastomosis for slow transit constipation

Authors: Xiu-Mei Deng, Tian-Yu Zhu, Guo-Jun Wang, Bu-Lang Gao, Rui-Xin Li, Jing-Tao Wang

Published in: Updates in Surgery | Issue 4/2023

Abstract

To investigate the clinical efficacy of laparoscopic total colectomy with ileorectal anastomosis (TC-IRA) and laparoscopic subtotal colectomy with antiperistaltic cecorectal anastomosis (SC-ACRA) on adults with slow transit constipation (STC). One hundred and three patients with STC were assigned to the TC-IRA group (n = 53) and the SC-ACRA group (n = 50). The clinical data were analyzed. The surgery was successful in all patients (100%). Significantly (P = 0.03) more patients took anti-laxatives during hospitalization in the TC-IRA than the SC-ACRA group (39.62% vs. 20.00%). Abdominal pain and distension was present in 33.96% and 32.00% patients in the TC-IRA and SC-ACRA group, respectively, which decreased insignificantly (P > 0.05) to 18.87% and 18.00% 24 months after surgery, respectively. The postoperative Wexner and gastrointestinal quality of life (GIQLI) scores were not significantly different (P > 0.05) at all times after surgery in both groups. The defecation frequency decreased in both groups, and the average defecation frequency was significantly (P < 0.05) higher in the TC-IRA than the SC-ACRA group (3.91 ± 1.23 vs. 3.14 ± 1.15 times/day) at 3 months. Three months after surgery, significantly (P < 0.05) fewer patients were satisfied with defecation frequency in the TC-IRA than the SC-ACRA group (29 vs. 37 patients), whereas the number of patients who were willing to choose the same procedure again was not significantly (P > 0.05) different between the two groups. The WIS score of patients was significantly (P = 0.035) higher in the TC-IRA than the SC-ACRA group (6 vs. 5) 3 months later. TC-IRA and SC-ACRA are both safe and effective for adult slow transit constipation, and can significantly improve the quality of life of patients. Even though SC-ACRA has better early defecation frequency, postoperative antidiarrheal application and satisfaction, the long-term follow-up effects are similar.

Suares NC, Ford AC (2011) Prevalence of, and risk factors for, chronic idiopathic constipation in the community: systematic review and meta-analysis[J]. Am J Gastroenterol 106(9):1582–1591 (quiz 1581, 1592)CrossRefPubMed

Bharucha AE, Lacy BE (2020) Mechanisms, Evaluation, and Management of Chronic Constipation[J]. Gastroenterology 158(5):1232-1249 e1233CrossRefPubMed

Dudekula A, Huftless S, Bielefeldt K (2015) Colectomy for constipation: time trends and impact based on the US Nationwide Inpatient Sample, 1998–2011[J]. Aliment Pharmacol Ther 42(11–12):1281–1293CrossRefPubMed

Chu H, Zhong L, Li H et al (2014) Epidemiology characteristics of constipation for general population, pediatric population, and elderly population in china[J]. Gastroenterol Res Pract 2014:532734CrossRefPubMedPubMedCentral

Frattini JC, Nogueras JJ (2008) Slow transit constipation: a review of a colonic functional disorder[J]. Clin Colon Rectal Surg 21(2):146–152CrossRefPubMedPubMedCentral

Rao SS, Bharucha AE, Chiarioni G, et al. (2016) Functional Anorectal Disorders[J]. Gastroenterology

Patton V, Balakrishnan V, Pieri C et al (2020) Subtotal colectomy and ileorectal anastomosis for slow transit constipation: clinical follow-up at median of 15 years[J]. Tech Coloproctol 24(2):173–179CrossRefPubMed

Serra J, Pohl D, Azpiroz F et al (2020) European society of neurogastroenterology and motility guidelines on functional constipation in adults[J]. Neurogastroenterol Motil 32(2):e13762CrossRefPubMed

He CL, Burgart L, Wang L et al (2000) Decreased interstitial cell of cajal volume in patients with slow-transit constipation[J]. Gastroenterology 118(1):14–21CrossRefPubMed

10.

Bharucha AE, Pemberton JH, Locke GR 3rd (2013) American gastroenterological association technical review on constipation[J]. Gastroenterology 144(1):218–238CrossRefPubMed

11.

Katsumata R, Manabe N, Fujita M et al (2021) Colorectal neoplasms in melanosis coli: a survey in Japan and a worldwide meta-analysis[J]. Int J Colorectal Dis 36(10):2177–2188CrossRefPubMed

12.

Arebi N, Kalli T, Howson W et al (2011) Systematic review of abdominal surgery for chronic idiopathic constipation[J]. Colorectal Dis 13(12):1335–1343CrossRefPubMed

13.

Macha MR (2019) The feasibility of laparoscopic subtotal colectomy with cecorectal anastomosis in community practice for slow transit constipation[J]. Am J Surg 217(5):974–978CrossRefPubMed

14.

Xie XY, Sun KL, Chen WH et al (2019) Surgical outcomes of subtotal colectomy with antiperistaltic caecorectal anastomosis vs total colectomy with ileorectal anastomosis for intractable slow-transit constipation[J]. Gastroenterol Rep (Oxf) 7(6):449–454CrossRefPubMed

15.

Sailer M (2022) Slow transit constipation[J]. Chirurg 93(1):103–112CrossRefPubMed

16.

Knowles CH, Grossi U, Chapman M et al (2017) Surgery for constipation: systematic review and practice recommendations: results I: colonic resection[J]. Colorectal Dis 19(Suppl 3):17–36CrossRefPubMed

17.

Sohn G, Yu CS, Kim CW et al (2011) Surgical outcomes after total colectomy with ileorectal anastomosis in patients with medically intractable slow transit constipation[J]. J Korean Soc Coloproctol 27(4):180–187CrossRefPubMedPubMedCentral

18.

Yang D, He L, Su TR et al (2019) Outcomes of laparoscopic subtotal colectomy with cecorectal anastomosis for slow-transit constipation: a single center retrospective study[J]. Acta Chir Belg 119(2):83–87CrossRefPubMed

19.

Annicchiarico A, Dalmonte G, Cecconi S et al (2021) Laparoscopic subtotal colectomy with antiperistaltic caecorectal anastomosis in severe slow transit constipation—a video vignette[J]. Colorectal Dis 23(2):557–559CrossRefPubMed

20.

Mearin F, Lacy BE, Chang L, et al. (2016) Bowel Disorders[J]. Gastroenterology

21.

Pfeifer J (2015) Surgical options to treat constipation: a brief overview[J]. Rozhl Chir 94(9):349–361PubMed

22.

Rao SS, Sadeghi P, Beaty J et al (2004) Ambulatory 24-h colonic manometry in slow-transit constipation[J]. Am J Gastroenterol 99(12):2405–2416CrossRefPubMed

23.

Ravi K, Bharucha AE, Camilleri M et al (2010) Phenotypic variation of colonic motor functions in chronic constipation[J]. Gastroenterology 138(1):89–97CrossRefPubMed

24.

Eypasch E, Williams JI, Wood-Dauphinee S et al (1995) Gastrointestinal quality of life index: development, validation and application of a new instrument[J]. Br J Surg 82(2):216–222CrossRefPubMed

25.

Wu CW, Pu TW, Kang JC et al (2021) Preservation of superior rectal artery in laparoscopically assisted subtotal colectomy with ileorectal anastomosis for slow transit constipation[J]. World J Gastroenterol 27(22):3121–3129CrossRefPubMedPubMedCentral

26.

Wang DY, Lin JJ, Xu XM et al (2013) The role of hand-assisted laparoscopic surgery in total colectomy for colonic inertia: a retrospective study[J]. J Korean Surg Soc 85(3):123–127CrossRefPubMedPubMedCentral

27.

Fan WC, Huang CC, Sung A et al (2016) Laparoscopic total colectomy with transrectal specimen extraction and intraabdominal ileorectal anastomosis for slow-transit constipation (with video)[J]. J Visc Surg 153(4):309–310CrossRefPubMed

28.

Lillehei RC, Wangensteen OH (1955) Bowel function after colectomy for cancer, polyps, and diverticulitis[J]. J Am Med Assoc 159(3):163–170CrossRefPubMed

29.

Cong-Qing J, Qun Q, Zhong-Li A, Yue-Ming H, Zhi-Su L, Jin-Xiang H, Ke-Yan Z, Yun-Hua W (2007) Long-term results of subtotal colectomy with antiperistaltic cecoproctostomy in chronic slow-transit constipation. Zhonghua Wai Ke Za Zhi 45(15):1041–1043 (Article in Chinese)

30.

Wei D, Cai J, Yang Y et al (2015) A prospective comparison of short term results and functional recovery after laparoscopic subtotal colectomy and antiperistaltic cecorectal anastomosis with short colonic reservoir vs. long colonic reservoir[J]. BMC Gastroenterol 15:30CrossRefPubMedPubMedCentral

31.

Li F, Fu T, Tong W et al (2014) Effect of different surgical options on curative effect, nutrition, and health status of patients with slow transit constipation[J]. Int J Colorectal Dis 29(12):1551–1556CrossRefPubMed

32.

Feng Y, Jianjiang L (2008) Functional outcomes of two types of subtotal colectomy for slow-transit constipation: ileosigmoidal anastomosis and cecorectal anastomosis[J]. Am J Surg 195(1):73–77CrossRefPubMed

33.

Hassan I, Pemberton JH, Young-Fadok TM et al (2006) Ileorectal anastomosis for slow transit constipation: long-term functional and quality of life results[J]. J Gastrointest Surg 10(10):1330–1336CrossRefPubMed

34.

Reshef A, Alves-Ferreira P, Zutshi M et al (2013) Colectomy for slow transit constipation: effective for patients with coexistent obstructed defecation[J]. Int J Colorectal Dis 28(6):841–847CrossRefPubMed

35.

Wilkinson-Smith V, Bharucha AE, Emmanuel A et al (2018) When all seems lost: management of refractory constipation-surgery, rectal irrigation, percutaneous endoscopic colostomy, and more[J]. Neurogastroenterol Motil 30(5):e13352CrossRefPubMed

36.

Jolly S, Dudi-Venkata NN, Hanna-Rivero N et al (2020) Four different ileorectal anastomotic configurations following total colectomy[J]. ANZ J Surg 90(9):1588–1591CrossRefPubMed

Title: Laparoscopic total colectomy with ileorectal anastomosis and subtotal colectomy with antiperistaltic cecorectal anastomosis for slow transit constipation
Authors: Xiu-Mei Deng
Tian-Yu Zhu
Guo-Jun Wang
Bu-Lang Gao
Rui-Xin Li
Jing-Tao Wang
Publication date: 14-03-2023
Publisher: Springer International Publishing
Keywords: Constipation
Colectomy
Subtotal Colectomy
Colectomy
Subtotal Colectomy
Constipation
Published in: Updates in Surgery / Issue 4/2023
Print ISSN: 2038-131X
Electronic ISSN: 2038-3312
DOI: https://doi.org/10.1007/s13304-023-01458-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Laparoscopic total colectomy with ileorectal anastomosis and subtotal colectomy with antiperistaltic cecorectal anastomosis for slow transit constipation

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 4/2023

The difficulty grade of laparoscopic hepatectomy for hepatocellular carcinoma correlates with long-term outcomes

Reflux disease following primary sleeve gastrectomy: risk factors and possible causes

Value of gallbladder length-to-width ratio for diagnosis of biliary atresia by correlation with age

Minimally invasive surgery and liver transplantation: is it a safe, feasible, and effective approach?

Robot-assisted esophagectomy with robot-sewn intrathoracic anastomosis (Ivor Lewis): surgical technique and early results

Minimally invasive technique for gastric GIST at challenging locations: single incision surgical gastroscopy