Although surgical options for slow transit constipation (STC) have been proven to be a definite treatment, improvements in the associated defecation function and quality of life are rarely studied. This study aims to investigate the effectiveness of total or subtotal colectomy, with respect to short- and long-term defecation function and overall quality of life in 5-year regular follow-up.
Constipation is an ever-growing problem and one of the most common gastrointestinal symptoms, affecting 10-15% of adults in the USA and 8.2% of the general population in China. Slow-transit constipation, representing 15\~30% constipated patients, is characterized by a loss in the colonic motor activity. Factors such as increasing age, female sex, physical inactivity, endocrine, metabolism, neurological factors, drug use, and depression are associated with constipation. While most patients with constipation are mild and treated easily by a behavioral and medical way, a minority of patients suffering from long-term intractable symptoms and poor quality of life and showing no response to any medical interventions are ultimately recommended for surgery. Since the effectiveness of colectomy for constipation was first reported by Lane a century ago, surgical treatment for constipation has been greatly developed\[6\], including ileorectal anastomosis (IRA), cecorectal anastomosis(CRA), colonic exclusion, antegrade enemas (the Malone procedure), modified Duhamel surgery, and permanent ileostomy. Currently, the main surgical procedures for STC are IRA and CRA, which have been widely confirmed to increase bowel-movement frequency in a huge number of patients. However, the reported outcomes of colectomy are controversial and conflicting.In these studies, lack of prospectively defined follow-up intervals is a general problem. Moreover, long-term outcomes of surgery for STC are rarely reported. Furthermore, negatively persistent symptoms including abdominal pain, bloating, intractable diarrhea, malnutrition, constipation recurrence, fecal incontinence, and intestinal obstruction are not uncommon following surgery, adversely affecting defecation function and quality of life following these procedures. This study aims to investigate the effectiveness of total or subtotal colectomy, with respect to short- and long-term defecation function and overall quality of life during 5-year regular follow-up.
Study Type
OBSERVATIONAL
Enrollment
100
all patients underwent total colectomy and ileorectal anastomosis.The anastomosis was stapled in all patients.
Weidong Tong
Yuzhong, Chongqing Municipality, China
RECRUITINGThe number of bowel movements
the number of bowel movements will be recorded in terms of times per week.
Time frame: from the pre-operation to the five years following surgery
The scales of Wexner Constipation
the scales of Wexner Constipation will be recorded in terms of scores.
Time frame: from the pre-operation to the five years following surgery
The scales of Wexner Incontinence
the scales of Wexner Incontinence will be recorded in terms of scores.
Time frame: from the pre-operation to the five years following surgery
The incidence of abdominal pain
the incidence of abdominal pain will be recorded in terms of percent.
Time frame: from the pre-operation to the five years following surgery
The incidence of bloating
the incidence of bloating will be recorded in terms of percent.
Time frame: from the pre-operation to the five years following surgery
The incidence of diarrhea
the incidence of diarrhea will be recorded in terms of percent.
Time frame: from the pre-operation to the five years following surgery
The incidence of straining
the incidence of straining will be recorded in terms of percent.
Time frame: from the pre-operation to the five years following surgery
The incidence of laxative
the incidence of laxative will be recorded in terms of percent.
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Time frame: from the pre-operation to the five years following surgery
The incidence of enema use
the incidence of enema use will be recorded in terms of percent.
Time frame: from the pre-operation to the five years following surgery
The scales of Gastrointestinal Quality of Life Index
the scales of Gastrointestinal Quality of Life Index will be recorded in terms of scores.
Time frame: from the pre-operation to the five years following surgery
The short-form(SF)-36 survey
There are eight spheres in the SF-36 survey, including physical function, role physical, role emotional, physical pain, vitality, mental health, social function and general health. Results of each sphere will be recorded in terms of scores.
Time frame: from the pre-operation to the five years following surgery
Number of Participants with complications
Postoperative complications includes short-term and long-term complications, such as ileus, anastomotic leak, small intestinal obstruction, constipation recurrence and so on. Number of Participants with complications will be recorded.
Time frame: from the pre-operation to the five years following surgery