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Long-term response to subtotal colectomy in colonic inertia

  • Published:
Journal of Gastrointestinal Surgery

Abstract

The purpose of this study was to determine the long-term outcome of patients who had previously undergone subtotal colectomy for severe idiopathic constipation at the University of Florida between 1983 and 1987. In addition, we aimed to determine whether preoperative motility abnormalities of the upper gastrointestinal tract are more common among those patients who have significant postoperative complications after subtotal colectomy. We valuated 13 patients who underwent subtotal colectomy for refractory constipation between 1983 and 1987 at the University of Florida. Preoperatively, all patients exhibited a pattern consistent with colonic inertia as demonstrated by means of radiopaque markers. Each patient was asked to quantitate the pain intensity and frequency of their bowel movements before and after surgery. In seven patients an ileosigmoid anastomosis was performed, whereas in six patients an ileorectal anastomosis was used. Abdominal pain decreased after subtotal colectomy. Patients with abnormal upper gastrointestinal motility preoperatively experienced greater postoperative pain than those with normal motility regardless of the type of anastomosis. In addition, the number of postoperative surgeries was similar in those patients with abnormal upper motility compared to those with normal motility. Overall, the total number of bowel movements per week increased from 0.5 ± 0.03 preoperatively to 15 ± 4.5 (P < 0.007) postoperatively. The results of our study suggest that patients with isolated colonic inertia have a better long-term outcome from subtotal colectomy than patients with additional upper gastrointestinal motility abnormalities associated with their colonic inertia.

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Authors and Affiliations

  1. Department of Medicine and Surgery, Malcom Randall Veterans Affairs Medical Center, Gainesville, Florida

    G. Nicholas Verne, M. P. Hocking, R. H. Davis, R. J. Howard & M. M. Sabetai

  2. University of Florida, and Digestive Disease Associates, Gainesville, Florida

    C. A. Sninsky

  3. Gastrointestinal Consultants of Houston, PA, Houston, Texas

    J. R. Mathias

  4. Department of Medicine, University of Washington School of Medicine, Pacific Medical Center, and the Veterans Affairs Medical Center, Seattle, Washington

    M. D. Schuffler

Authors
  1. G. Nicholas Verne
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  2. M. P. Hocking
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  3. R. H. Davis
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  4. R. J. Howard
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  5. M. M. Sabetai
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  6. J. R. Mathias
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  7. M. D. Schuffler
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  8. C. A. Sninsky
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Correspondence to G. Nicholas Verne.

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Verne, G.N., Hocking, M.P., Davis, R.H. et al. Long-term response to subtotal colectomy in colonic inertia. J Gastrointest Surg 6, 738–744 (2002). https://doi.org/10.1016/S1091-255X(02)00022-7

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  • DOI: https://doi.org/10.1016/S1091-255X(02)00022-7

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