Published online May 26, 2020. doi: 10.12998/wjcc.v8.i10.1897
Peer-review started: December 31, 2019
First decision: January 16, 2020
Revised: March 27, 2020
Accepted: April 17, 2020
Article in press: April 17, 2020
Published online: May 26, 2020
Although total or subtotal colectomy for slow-transit constipation (STC) has been proven to be a definite treatment, the associated defecation function and quality of life (QOL) are rarely studied.
To evaluate the effectiveness of surgery for STC regarding defecation function and QOL.
From March 2013 to September 2017, 30 patients undergoing surgery for STC in our department were analyzed. Preoperative, intra-operative, and postoperative 3-mo, 6-mo, 1-year, and 2-year follow-up details were recorded. Defecation function was assessed by bowel movements, abdominal pain, bloating, straining, laxative, enema use, diarrhea, and the Wexner constipation and incontinence scales. QOL was evaluated using the gastrointestinal QOL index and the 36-item short form survey.
The majority of patients (93.1%, 27/29) stated that they benefited from the operation at the 2-year follow-up. At each time point of the follow-up, the number of bowel movements per week significantly increased compared with that of the preoperative conditions (P < 0.05). Similarly, compared with the preoperative values, a marked decline was observed in bloating, straining, laxative, and enema use at each time point of the follow-up (P < 0.05). Postoperative diarrhea could be controlled effectively and notably improved at the 2-year follow-up. The Wexner incontinence scores at 6-mo, 1-year, and 2-year were notably lower than those at the 3-mo follow-up (P < 0.05). Compared with those of the preoperative findings, the Wexner constipation scores significantly decreased following surgery (P < 0.05). Thus, it was reasonable to find that the gastrointestinal QOL index scores clearly increase (P < 0.05) and that the 36-item short form survey results displayed considerable improvements in six spheres (role physical, role emotional, physical pain, vitality, mental health, and general health) following surgery.
Total or subtotal colectomy for STC is not only effective in alleviating constipation-related symptoms but also in enhancing patients’ QOL.
Core tip: Although total or subtotal colectomy for slow-transit constipation has been proven to be a definite treatment, the associated defecation function and quality of life are rarely studied. The reported outcomes of colectomy for constipation are various, controversial, and conflicting. Based on our study of 2-year follow-up data following surgery, total or subtotal colectomy for slow-transit constipation is not only effective in alleviating constipation-related symptoms but also in enhancing patients’ quality of life.