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Quality of Life After Subtotal Colectomy for Slow-Transit Constipation

Both Quality and Quantity Count

  • Published:
Diseases of the Colon & Rectum

Abstract

PURPOSE: Subtotal colectomy reliably increases bowel-movement frequency in patients with slow-transit constipation, but its impact on quality of life is unknown. The purpose of this study was to assess the relationship between functional outcomes and quality of life after subtotal colectomy for slow-transit constipation. METHODS: We reviewed the charts and operative reports of all patients who underwent subtotal colectomy for slow-transit constipation from January 1992 to June 2001. We sent them a 54-question survey that inquired about bowel function and included a modified 36-item gastrointestinal quality-of-life index. Using Pearson’s R, we correlated gastrointestinal quality-of-life index scores with specific functional outcomes. RESULTS: Of 112 patients (109 females), 28 had been lost to follow-up and 2 had died. In all, 75 surveys (67 percent) were returned. Most of these 75 patients (81 percent) were at least somewhat pleased with their bowel-movement frequency, but 41 percent cited abdominal pain; 21 percent, incontinence; and 46 percent, diarrhea at least some of the time. The overall mean gastrointestinal quality-of-life index score was 103 ± 22 of a maximum possible score of 144 (mean score for healthy controls, 126 ± 13). We found no correlation between frequency of bowel movements and gastrointestinal quality-of-life index score (R = −0.03). Abdominal pain, diarrhea, and incontinence each had a statistically significant negative impact on gastrointestinal quality-of-life index scores (P = 0.01). Patients who required permanent ileostomy had low gastrointestinal quality-of-life index scores (68 ± 24). The vast majority (93 percent) of patients stated they would undergo subtotal colectomy again if given a second chance. CONCLUSION: Subtotal colectomy for slow-transit constipation increases bowel-movement frequency; however, the persistence of abdominal pain and the development of postoperative incontinence or diarrhea adversely affect quality of life. Although most patients in the present study were satisfied with their results, quality-of-life scores should be used to assess postoperative outcome.

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References

  1. WA Lane (1908) ArticleTitleThe results of the operative treatment of chronic constipation Br Med J 1 126–130

    Google Scholar 

  3. DM Preston PR Hawley JE Lennard-Jones IP Todd (1984) ArticleTitleResults of colectomy for severe idiopathic constipation in women (Arbuthnot Lane’s Disease) Br J Surg 71 547–552

    Google Scholar 

  4. SH Leon S Krishnamurthy MD Schuffler (1987) ArticleTitleSubtotal colectomy for severe idiopathic constipation Dig Dis Sci 32 1249–1254

    Google Scholar 

  5. MA Kamm PR Hawley JE Lennard-Jones (1988) ArticleTitleOutcome of colectomy for severe idiopathic constipation Gut 29 969–973

    Google Scholar 

  6. CA Vasilevsky FD Nemer EG Balcos CE Christenson SM Goldberg (1988) ArticleTitleIs subtotal colectomy a viable option in the management of chronic constipation? Dis Colon Rectum 81 679–681

    Google Scholar 

  7. ME Zenilman DL Dunnegan NJ Soper JM Becker (1989) ArticleTitleSuccessful surgical treatment of idiopathic colonic dysmotility. The role of preoperative evaluation of coloanal motor function Arch Surg 124 947–951

    Google Scholar 

  8. DE Beck VW Fazio DG Jagelman IC Lavery (1989) ArticleTitleSurgical management of colonic inertia South Med J 82 305–309

    Google Scholar 

  9. K Yoshioka MR Keighley (1989) ArticleTitleClinical results of colectomy for severe constipation Br J Surg 76 600–604

    Google Scholar 

  10. JH Pemberton DM Rath DM Ilstrup (1991) ArticleTitleEvaluation and surgical treatment of severe chronic constipation Ann Surg 214 403–411

    Google Scholar 

  11. SD Wexner N Daniel DG Jagelman (1991) ArticleTitleColectomy for constipation Dis Colon Rectum 34 851–856

    Google Scholar 

  12. DK Rex JC Lappas RC Goulet JA Madura (1992) ArticleTitleSelection of constipated patients as subtotal colectomy candidates J Clin Gastroenterol 15 212–217

    Google Scholar 

  13. GT Sunderland FW Poon J Lauder IG Finlay (1992) ArticleTitleVideoproctography in selecting patients with constipation for colectomy Dis Colon Rectum 35 235–237

    Google Scholar 

  14. MF Piccirillo P Reissman SD Wexner (1995) ArticleTitleColectomy as treatment of constipation in selected patients Br J Surg 82 898–901

    Google Scholar 

  15. JM Redmond GW Smith I Barofsky RE Ratych DC Goldborough MM Schuster (1995) ArticleTitlePhysiological tests to predict long-term outcome of total abdominal colectomy for intractable constipation Am J Gastroenterol 90 748–753

    Google Scholar 

  16. DZ Lubowski FC Chen ML Kennedy DW King (1996) ArticleTitleResults of colectomy for severe slow transit constipation Dis Colon Rectum 39 23–29

    Google Scholar 

  17. H Pluta KL Bowes LD Jewell (1996) ArticleTitleLong-term results of total abdominal colectomy for chronic idiopathic constipation Dis Colon Rectum 39 160–166

    Google Scholar 

  18. C Platell D Scache G Mumme R Stitz (1996) ArticleTitleA long-term follow-up of patients undergoing colectomy for chronic idiopathic constipation Aust N Z J Surg 66 525–529

    Google Scholar 

  19. YH Ho M Tam KW Eu FS Choen (1997) ArticleTitleLaparoscopic-assisted compared with open total colectomy in treating slow transit constipation Aust N Z J Surg 67 562–565

    Google Scholar 

  20. DC Nyam JH Pemberton DM Ilstrup DM Rath (1997) ArticleTitleLong-term results of surgery for chronic constipation Dis Colon Rectum 40 273–279

    Google Scholar 

  21. A Bernini RD Madoff AC Lowry et al. (1998) ArticleTitleShould patients with combined colonic inertia and nonrelaxing pelvic floor undergo subtotal colectomy? Dis Colon Rectum 41 1363–1366

    Google Scholar 

  22. AJ Pikarsky JJ Singh EG Weiss JJ Nogueras SD Wexner (2001) ArticleTitleLong-term follow-up of patients undergoing colectomy for colonic inertia Dis Colon Rectum 44 179–183

    Google Scholar 

  23. JF Lim YH Ho (2001) ArticleTitleTotal colectomy with ileorectal anastomosis leads to appreciable loss in quality of life irrespective of primary diagnosis Tech Coloproctol 5 79–83

    Google Scholar 

  24. E Eypasch JI Williams S Wood-Dauphinee et al. (1995) ArticleTitleGastrointestinal quality of life index Br J Surg 82 216–222

    Google Scholar 

  25. CH Knowles M Scott PJ Lunniss (1999) ArticleTitleOutcome of colectomy for slow transit constipation Ann Surg 230 627–638

    Google Scholar 

  26. PV Walsh DA Peebles-Brown G Watkinson (1987) ArticleTitleColectomy for slow transit constipation Ann R Coll Surg Engl 69 71–75

    Google Scholar 

  27. S Akervall S Fasth S Nordgren T Oresland L Hulten (1988) ArticleTitleThe functional results after colectomy and ileorectal anastomosis for severe constipation (Arbuthnot Lane’s disease) as related to rectal sensory function Int J Colorectal Dis 3 96–101

    Google Scholar 

  28. J Christiansen OO Rasmussen (1996) ArticleTitleColectomy for severe slow-transit constipation in strictly selected patients Scand J Gastroenterol 31 770–773

    Google Scholar 

  29. EJ de Graaf EC Gilberts WR Schouten (1996) ArticleTitleRole of segmental colonic transit time studies to select patients with slow transit constipation for partial left-sided or subtotal colectomy Br J Surg 83 648–651

    Google Scholar 

  30. YT You JY Wang CR Changchien et al. (1998) ArticleTitleSegmental colectomy in the management of colonic inertia Am Surg 64 775–777

    Google Scholar 

  31. S Ghosh M Papachrysostomou M Batool MA Eastwood (1996) ArticleTitleLong-term results of sub-total colectomy and evidence of noncolonic involvement in patients with idiopathic slow-transit constipation Scand J Gastroenterol 31 1083–1091

    Google Scholar 

  32. ES Hughes FT McDermott WR Johnson AC Poglase (1981) ArticleTitleSurgery for constipation Aust N Z J Surg 51 144–148

    Google Scholar 

  33. K Thaler A Dinnewitzer EG Weiss et al. (2002) ArticleTitleQuality of life does not equate with functional outcome after colectomy for colonic inertia [abstract] Dis Colon Rectum 45 11–12

    Google Scholar 

  34. JE Ware CD Sherbourne (1992) ArticleTitleThe MOS 36-item short-form health survey (SF-36) Med Care 30 473–483

    Google Scholar 

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Authors and Affiliations

    Authors
    1. Gregory P. FitzHarris M.D.
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    2. Julio Garcia-Aguilar M.D., Ph.D.
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    3. Susan C. Parker M.D.
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    4. Kelli M. Bullard M.D.
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    5. Robert D. Madoff M.D.
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    6. Stanley M. Goldberg M.D.
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    7. Ann Lowry M.D.
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    FitzHarris, G.P., Garcia-Aguilar, J., Parker, S.C. et al. Quality of Life After Subtotal Colectomy for Slow-Transit Constipation. Dis Colon Rectum 46, 433–440 (2003). https://doi.org/10.1007/s10350-004-6576-3

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