Jalife-Montaño A, Morales-Díaz A, Cervantes-Sánchez CR, Pulido-Muñoz MA, Cuevas- Montes de Oca F, Ramírez TD, Ortega LLH, Vargas DA

Language: Spanish
References: 14
Page: 23-27
PDF size: 58.66 Kb.

ABSTRACT

Objective: To compare the results between segmental colonic resection and subtotal colectomy for the treatment of severe chronic constipation.
Setting: Third level health care hospitals.
Design: Prospective, comparative study with historical controls.
Statistical analysis: Chi square and Student’s t tests.
Patients and methods: We studied patients with severe chronic constipation. From 1994 to 1996, seven cases with segmental resection (left hemicolectomy). From 1996 to 2001, fourteen cases with subtotal colectomy, five of them had been previously subjected to segmental resection for the same reason without resolving the constipation. Each case was followed for at least five years. We compared the number and quality of stools before and after surgery.
Results: Mean number of stools in the segmental resection group was of 1 per week before the surgery and from 1 to 2 after it during the first 6 months, after this time only two patients remained “cured”. In the subtotal colectomy, the mean number of stools before surgery was of 1 per week and from 3 to 4 per day after surgery. Regarding resolution of constipation, 2 of 7 patients (28.57%) were considered cured in the segmental resection group and 13 of 14 patients (92.8%) in the subtotal colectomy group (p = 0.05).
Conclusion: The best treatment that can be offered to patients with colonic inertia manifested as idiopathic severe chronic constipation is subtotal colectomy with ileo-procto-anastomosis.

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