Skip to main content

Advertisement

SpringerLink
Log in

Single-incision clipless laparoscopic total colectomy for intractable slow transit constipation: a single surgeon’s experience

  • How-I-Do-It articles
  • Published:
Langenbeck's Archives of Surgery Aims and scope Submit manuscript

Abstract

Purpose

In our institution, patients with intractable slow transit constipation (STC) have undergone single-incision clipless laparoscopic total colectomy (SCLTC) with ileorectal anastomosis (IRA) since 2011. We aimed to examine the feasibility and usefulness of SCLTC with IRA for patients with intractable STC.

Methods

From January 2011 to December 2018, twenty-two patients with intractable STC underwent SCLTC with IRA at Kashiwa Hospital, Jikei University, by a single surgeon, were retrospectively registered in this study. They consisted of the first 12 consecutive patients undergoing the double stapling technique (DST) with IRA (DST group) and the last 10 consecutive patients undergoing functional end-to-end anastomosis (FEEA) with IRA (FEEA group).

Results

The median surgical time was 185 (150–249) min for the FEEA group and 230 (180–266) min for the DST group. A significant difference was identified between the two groups (0.035). There were no significant differences between the groups with respect to the median age, sex, body mass index, constipation type, intraoperative blood loss, postoperative hospital stay, or no use of laxatives daily stool frequency 1 month after surgery. No postoperative complications, such as anastomotic leakage, bowel obstruction, or bleeding related to vessel sealing device, were encountered in either group more than 3 years after surgery.

Conclusion

Our results suggest that SCLTC with IRA is feasible and safe for patients with intractable STC. SCLTC with IRA using FEEA is especially preferred to that using DST for patients with intestinal contents in the rectum that cannot be completely removed by pre- and intraoperative preparation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8

Similar content being viewed by others

Abbreviations

STC:

Slow transit constipation

SCLTC:

Single-incision clipless laparoscopic total colectomy

IRA:

Ileorectal anastomosis

DST:

Double stapling technique

FEEA:

Functional end-to-end anastomosis

References

  1. Lane WA (1908) The results of operative treatment of chronic constipation. Br Med J 1:126–130. https://doi.org/10.1136/bmj.1.2455.126

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Lane WA (1909) Chronic intestinal stasis. Br Med J 1(2528):1408–1411. https://doi.org/10.1136/bmj.1.2528.1408

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Sohn G, Yu CS, Kim CW, Kwak JY, Jang TY, Kim KH, Yang SS, Yoon YS, Lim SB, Kim JC (2011) Surgical outcomes after total colectomy with ileorectal anastomosis in patients with medically intractable slow transit constipation. J Korean Soc Coloproctol 27(4):180–187. https://doi.org/10.3393/jksc.2011.27.4.180

    Article  PubMed  PubMed Central  Google Scholar 

  4. McCoy JA, Beck DE (2012) Surgical management of colonic inertia. Clin Colon Rectal Surg 25(1):20–23. https://doi.org/10.1055/s-0032-1301755

    Article  PubMed  PubMed Central  Google Scholar 

  5. Reshef A, Alves-Ferreira P, Zutshi M, Hull T, Gurland B (2013) Colectomy for slow transit constipation: effective for patients with coexistent obstructed defecation. Int J Colorectal Dis 28(6):841–847. https://doi.org/10.1007/s00384-012-1498-3

    Article  PubMed  Google Scholar 

  6. Sheng QS, Lin JJ, Chen WB, Liu FL, Xu XM, Hua HJ, Lin CZ, Wang JH (2014) Comparison of hand-assisted laparoscopy with open total colectomy for slow transit constipation: a retrospective study. J Dig Dis 15(8):419–424. https://doi.org/10.1111/1751-2980.12156

    Article  PubMed  Google Scholar 

  7. Kawahara H, Watanabe K, Tomoda M, Enomoto H, Akiba T, Yanaga K (2014) Single-incision clipless laparoscopic total colectomy. Hepatogastroenterol 61:453–455

    Google Scholar 

  8. Kawahara H, Omura N, Akiba T (2021) The usefulness of preoperative evaluation for intractable slow transit constipation by computed tomography. J Anus Rectum Colon 5(2):144–147. https://doi.org/10.23922/jarc.2020-065

    Article  PubMed  PubMed Central  Google Scholar 

  9. Markar SR, Wiggins T, Penna M, Paraskeva P (2014) Single-incision versus conventional multiport laparoscopic colorectal surgery-systematic review and pooled analysis. J Gastrointest Surg 18(12):2214–2227. https://doi.org/10.1007/s11605-014-2654-6

    Article  PubMed  Google Scholar 

  10. Hirano Y, Hattori M, Douden K, Ishiyama Y, Hashizume Y (2016) Single-incision laparoscopic surgery for colorectal cancer. World J Gastrointest Surg 8(1):95–100. https://doi.org/10.4240/wjgs.v8.i1.95

    Article  PubMed  PubMed Central  Google Scholar 

  11. Aldeghaither S, Zubaidi A, Alkhayal K, Al-Obaid O (2016) Single-incision laparoscopic colorectal surgery: a report of 33 cases in Saudi Arabia. Ann Saudi Med 36(4):282–287. https://doi.org/10.5144/0256-4947.2016.282

    Article  PubMed  PubMed Central  Google Scholar 

  12. Kawahara H, Watanabe K, Ushigome T, Noaki R, Kobayashi S, Yanaga K (2010) Umbilical incision laparoscopic surgery with one assist port for anterior resection. Dig Surg 27:364–366. https://doi.org/10.1159/000315012

    Article  PubMed  Google Scholar 

  13. Kawahara H, Watanabe K, Ushigome T, Yanagisawa S, Kabayashi S, Yanaga K (2011) Usefulness of one suprapubic assist port in umbilical incision laparoscopic surgery for right-side colon cancer. Hepatogastroenterol 58:1956–1958. https://doi.org/10.5754/hge11270

    Article  Google Scholar 

  14. Kawahara H, Watanabe K, Tomoda M, Enomoto H, Akiba T, Yanaga K (2014) Umbilical single incisional approach plus one port for partial transverse colectomy: initial operative experience. Hepatogastroenterol 61:1954–1956

    Google Scholar 

  15. Rimonda R, Arezzo A, Garrone C, Allaix ME, Giraudo G, Morino M (2009) Electrothermal bipolar vessel sealing system vs. harmonic scalpel in colorectal laparoscopic surgery: a prospective, randomized study. Dis Colon Rectum 52(4):657–61. https://doi.org/10.1007/DCR.0b013e3181a0a70a

    Article  PubMed  Google Scholar 

  16. Grieco M, Apa D, Spoletini D, Grattarola E, Carlini M (2018) Major vessel sealing in laparoscopic surgery for colorectal cancer: a single-center experience with 759 patients. World J Surg Oncol 16(1):101–105. https://doi.org/10.1186/s12957-018-1402-x

    Article  PubMed  PubMed Central  Google Scholar 

  17. Milsom JW, Trencheva K, Momose K, Peev MP, Christos P, Shukla PJ, Garrett K. (2021) A pilot randomized controlled trial comparing THUNDERBEAT to the Maryland LigaSure energy device in laparoscopic left colon surgery. Surg Endosc Nov 1. https://doi.org/10.1007/s00464-021-08765-8. Online ahead of print. (PMID: 34724584)

  18. Pinedo G, Zarate AJ, Garcia E, Molina ME, Lopez F, Zúñiga A (2009) Laparoscopic total colectomy for colonic inertia: surgical and functional results. Surg Endosc 23(1):62–65. https://doi.org/10.1007/s00464-008-9901-4

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, Kashiwa Hospital, Jikei University School of Medicine, 163-1 Kashiwashita, Kashiwashi, Chiba, 277-8567, Japan

    Hidejiro Kawahara

  2. Department of Surgery, National Organization Nishisaitama-Chuo National Hospital, Saitama, Japan

    Hidejiro Kawahara & Nobuo Omura

Authors
  1. Hidejiro Kawahara
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nobuo Omura
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Study conception and design: H.K. Acquisition of data: H.K. Analysis and interpretation of data: H.K, N.O. Drafting of manuscript: H.K. Critical revision of manuscript: H.K, N.O. Final approval of the version to be published: H.K, N.O.

Corresponding author

Correspondence to Hidejiro Kawahara.

Ethics declarations

Ethics approval

The Ethics Committee for Biomedical Research of the Jikei Institutional Review Board approved the protocol.

Informed consent

All participants provided informed consent prior to their participation.

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher's note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kawahara, H., Omura, N. Single-incision clipless laparoscopic total colectomy for intractable slow transit constipation: a single surgeon’s experience. Langenbecks Arch Surg 407, 2585–2593 (2022). https://doi.org/10.1007/s00423-022-02588-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00423-022-02588-4

Keywords

Search

Navigation