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World J Gastroenterol. Dec 28, 2006; 12(48): 7864-7868
Published online Dec 28, 2006. doi: 10.3748/wjg.v12.i48.7864
Colonic exclusion and combined therapy for refractory constipation
Hong-Yun Peng, Ai-Zhong Xu
Hong-Yun Peng, Ai-Zhong Xu, Department of General Surgery, The Second Affiliated Hospital, Nanchang University, Jiangxi Province, China
Supported by the Health Department of Jiangxi Province, No. 20041021
Correspondence to: Dr. Hong-Yun Peng, Department of General Surgery, The Second Affiliated Hospital, Nanchang University, Nanchang 330006, Jiangxi Province, China. penghongyun0855@sina.com
Telephone: +86-791-6291195 Fax: +86-791-6291195
Received: August 22, 2006
Revised: August 28, 2006
Accepted: November 24, 2006
Published online: December 28, 2006
Abstract

AIM: To investigate the therapeutic effectiveness of colonic exclusion and combined therapy for refractory constipation.

METHODS: Thirty-two patients with refractory constipation were randomly divided into treatment group (n = 14) and control group (n = 18). Fourteen patients in treatment group underwent colonic exclusion and end-to-side colorectal anastomosis. Eighteen patients in control group received subtotal colectomy and end-to-end colorectal anastomosis. The therapeutic effects of the operations were assessed by comparing the surgical time, incision length, volume of blood losses, hospital stay, recovery rate and complication incidence. All patients received long-term follow-up.

RESULTS: All operations were successful and patients recovered fully after the operations. In comparison of treatment group and control group, the surgical time (h), incision length (cm), volume of blood losses (mL), hospital stay (d) were 87 ± 16 min vs 194 ± 23 min (t = 9.85), 10.4 ± 0.5 cm vs 21.2 ± 1.8 cm (t = 14.26), 79.5 ± 31.3 mL vs 286.3 ± 49.2 mL (t = 17.24), and 11.8 ± 2.4 d vs 18.6 ± 2.6 d (t = 6.91), respectively (P < 0.001 for all). The recovery rate and complication incidence were 85.7% vs 88.9% (P = 0.14 > 0.05), 21.4% vs 33.3% (P = 0.73 > 0.05), respectively.

CONCLUSION: Colonic exclusion has better therapeutic efficacy on refractory constipation. It has many advantages such as shorter surgical time, smaller incision, fewer blood losses and shorter hospital stay.

Keywords: Constipation; Colonic exclusion; Subtotal colectomy; Quality of life; Follow-up