Rapid Communication
Copyright ©2007 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. May 14, 2007; 13(18): 2590-2595
Published online May 14, 2007. doi: 10.3748/wjg.v13.i18.2590
Long-term results of subtotal colectomy with cecorectal anastomosis for isolated colonic inertia
Antonio Iannelli, Thierry Piche, Raffaella Dainese, Pascal Fabiani, Albert Tran, Jean Mouiel, Jean Gugenheim
Antonio Iannelli, Pascal Fabiani, Jean Mouiel, Jean Gugenheim, Service de Chirurgie Digestive - Université de Nice-Sophia-Antipolis, Faculté de Médecine, Nice, F-06107, France & Centre Hospitalier Universitaire de Nice, Pôle Digestif, Nice, F-06107, France
Thierry Piche, Raffaella Dainese, Albert Tran, Service de Gastroentérologie - Université de Nice-Sophia-Antipolis, Faculté de Médecine, Nice, F-06107, France & Centre Hospitalier Universitaire de Nice, Pôle Digestif, Nice, F-06107, France
Thierry Piche, Inserm U526, Nice, F-06107, France
Author contributions: All authors contributed equally to the work.
Correspondence to: Dr. Thierry Piche, Service d’Hépato-gastroentérologie - Hôpital de l’Archet 2, 151 Route Saint-Antoine de Ginestière BP 3079, 06202-Nice-Cedex 3,France. tpiche@fc.horus-medical.fr
Telephone: +33-4-92036168 Fax: +33-4-92036575
Received: January 29, 2007
Revised: January 31, 2007
Accepted: February 14, 2007
Published online: May 14, 2007
Abstract

AIM: To evaluate the results of sub total colectomy with cecorectal anastomosis (STC-CRA) for isolated colonic inertia (CI).

METHODS: Fourteen patients (mean age 57.5 ± 16.5 year) underwent surgery for isolated CI between January 1986 and December 2002. The mean frequency of bowel motions with the aid of laxatives was 1.2 ± 0.6 per week. All subjects underwent colonoscopy, anorectal manometry, cinedefaecography and colonic transit time (CTT). CI was defined as diffuse markers delay on CTT without evidence of pelvic floor dysfunction. All patients underwent STC-CRA. Long-term follow-up was obtained prospectively by clinical visits between October 2005 and February 2006 at a mean of 10.5 ± 3.6 years (range 5-16 years) during which we considered the number of stool emissions, the presence of abdominal pain or digitations, the use of pain killers, laxatives and/or fibers. Patients were also asked if they were satisfied with the surgery.

RESULTS: There was no postoperative mortality. Postoperative complications occurred in 21.4% (3/14). At the end of follow-up, bowel frequency was significantly (P < 0.05) increased to a mean of 4.8 ± 7.5 per day (range 1-30). One patient reported disabling diarrhea. Two patients used laxatives less than three times per month without complaining of what they called constipation. Overall, 78.5% of patients would have chosen surgery again if necessary.

CONCLUSION: STC-CRA is feasible and safe in patients with CI achieving 79% of success at a mean follow-up of 10.5 years. A prospective controlled evaluation is warranted to verify the advantages of this surgical approach in patients with CI.

Keywords: Constipation; Colonic inertia; Surgery; Subtotal colectomy; Cecorectal anastomosis