Retrospective Cohort Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 7, 2015; 21(33): 9736-9740
Published online Sep 7, 2015. doi: 10.3748/wjg.v21.i33.9736
Comparison of two types of colectomy in treating slow transit constipation with or without melanosis coli
Ji-Wei Sun, Jia-Ni Gu, Peng Du, Wei Chen
Ji-Wei Sun, Jia-Ni Gu, Peng Du, Wei Chen, Department of Anal and Rectal Surgery, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
Author contributions: Sun JW and Chen W designed the research; Sun JW, Gu JN and Du P performed the research; Du P analyzed the data; Sun JW wrote the paper; and Chen W critically revised the manuscript for important intellectual content.
Institutional review board statement: The study was reviewed and approved by the Xin Hua Hospital Institutional Review Board.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: We declare that we have no financial or personal relationships with other people or organizations that can inappropriately influence our work, and there is no professional or other personal interest of any nature or kind in any product, service and/or company that could be construed as influencing the position presented in, or the review of, the manuscript.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at xinhuawmz1@126.com. Participants gave informed consent for data sharing. No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Wei Chen, MD, Professor, Department of Anal and Rectal Surgery, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No. 1665 Kongjiang Street, Shanghai 200092, China. xinhuawmz1@126.com
Telephone: +86-21-25078999 Fax: +86-21-25078999
Received: December 13, 2014
Peer-review started: December 16, 2014
First decision: January 22, 2015
Revised: February 27, 2015
Accepted: June 10, 2015
Article in press: June 10, 2015
Published online: September 7, 2015
Processing time: 267 Days and 19.3 Hours
Abstract

AIM: To compare the follow-up outcomes of ileosigmoidal anastomosis (ISA) and caecorectal anastomosis (CRA) in patients with slow transit constipation (STC) with or without melanosis coli (MC).

METHODS: We collected the clinical data of 48 STC patients with or without MC from May 2002 to May 2007. Twenty-six patients underwent CRA (14 with MC) and 22 cases received ISA (14 with MC). A 3-year postoperative follow-up was conducted.

RESULTS: CRA improved the quality of life [evaluated by the gastrointestinal quality of life index (GIQLI)] in patients without MC, but was inferior to ISA in stool frequency and Wexner and GIQLI scores for MC patients. In the CRA group, patients with MC suffered worse outcomes than those without MC.

CONCLUSION: CRA is more suitable for STC patients without MC; however, for STC patients with MC, ISA is a better choice.

Keywords: Constipation; Melanosis coli; Caecorectal anastomosis; Ileosigmoidal anastomosis; Prognosis

Core tip: The optimal surgical treatment for slow transit constipation (STC) is controversial. Based on our study, caecorectal anastomosis is more suitable for STC without melanosis coli (MC). However, for STC with MC, ileosigmoidal anastomosis, with a lower postoperative recurrence rate, is a better choice.