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Surgical Outcomes after Total Colectomy with Ileorectal Anastomosis in Patients with Medically Intractable Slow Transit Constipation

대한대장항문학회지 2011년 27권 4호 p.180 ~ 187
 ( Sohn Gui-Yun ) - University of Ulsan College of Medicine Asan Medical Center Department of Colon and Rectal Surgery

 ( Yu Chang-Sik ) - University of Ulsan College of Medicine Asan Medical Center Department of Colon and Rectal Surgery
 ( Kim Chan-Wook ) - University of Ulsan College of Medicine Asan Medical Center Department of Colon and Rectal Surgery
 ( Kwak Jae-Young ) - University of Ulsan College of Medicine Asan Medical Center Department of Colon and Rectal Surgery
 ( Jang Tae-Young ) - University of Ulsan College of Medicine Asan Medical Center Department of Colon and Rectal Surgery
 ( Kim Kyung-Ho ) - University of Ulsan College of Medicine Asan Medical Center Department of Colon and Rectal Surgery
 ( Yang Song-Soo ) - University of Ulsan College of Medicine Asan Medical Center Department of Colon and Rectal Surgery
 ( Yoon Yong-Sik ) - University of Ulsan College of Medicine Asan Medical Center Department of Colon and Rectal Surgery
 ( Lim Seok-Byung ) - University of Ulsan College of Medicine Asan Medical Center Department of Colon and Rectal Surgery
 ( Kim Jin-Cheon ) - University of Ulsan College of Medicine Asan Medical Center Department of Colon and Rectal Surgery

Abstract


Purpose: The aim of this study was to evaluate outcomes of a total colectomy with ileorectal anastomosis in patients with slow transit constipation.

Methods: A retrospective review of 37 consecutive patients with slow transit constipation who underwent a total colectomy between 1994 and 2008 was undertaken. Preoperative and postoperative Wexner’s constipation scores were collected and used to evaluate the outcomes after surgical treatment. Also patients’ postoperative satisfaction scores were collected using a 4-point scale.

Results: The 37 patients consisted of 31 women and 6 men, with a median age of 41 years (range, 17 to 71 years). Pre- and post-operative Wexner’s scores were collected from 33 patients (89.1%), and the mean preoperative Wexner’s score was 19.3 (range, 11 to 24), which decreased to an average post-operative score of 2.3 (range, 0 to 8). Neither intraoperative complications nor postoperative mortalities were noted. Five patients (13.5%) had early postoperative complications, and the most common complication was postoperative ileus (10.8%). Seven patients (18.9%) had late postoperative complications, and postoperative ileus (10.8%) was also the most common. Twenty seven of 33 patients were satisfied with their surgical outcome (81.8%).

Conclusion: A total colectomy with ileorectal anastomosis might be an effective surgical procedure with acceptable morbidity to treat medically intractable slow transit constipation.

키워드

Colonic inertia;Colectomy;Treatment outcome;Postoperative complication
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