Quality of life after subtotal colectomy for slow-transit constipation: both quality and quantity count - PubMed (original) (raw)
Quality of life after subtotal colectomy for slow-transit constipation: both quality and quantity count
Gregory P FitzHarris et al. Dis Colon Rectum. 2003 Apr.
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.
Comment in
- Quality of life after subtotal colectomy for constipation: selection of the right patient, operation, and tools to measure outcome.
Pemberton JH, Drelichman ER. Pemberton JH, et al. Dis Colon Rectum. 2003 Dec;46(12):1720-1; author reply 1721. doi: 10.1007/BF02660786. Dis Colon Rectum. 2003. PMID: 14668606 No abstract available.
Similar articles
- Subtotal colectomy with antiperistaltic cecorectal anastomosis in the treatment of slow-transit constipation: long-term impact on quality of life.
Marchesi F, Sarli L, Percalli L, Sansebastiano GE, Veronesi L, Di Mauro D, Porrini C, Ferro M, Roncoroni L. Marchesi F, et al. World J Surg. 2007 Aug;31(8):1658-64. doi: 10.1007/s00268-007-9111-6. World J Surg. 2007. PMID: 17541684 - [Retrospective cohort study on subtotal colonic bypass plus colostomy with antiperistaltic cecoproctostomy in the treatment of senile slow transit constipation].
Yang Y, Cao YL, Wang WH, Zhang YY, Zhao N, Wei D. Yang Y, et al. Zhonghua Wei Chang Wai Ke Za Zhi. 2019 Apr 25;22(4):370-376. doi: 10.3760/cma.j.issn.1671-0274.2019.04.010. Zhonghua Wei Chang Wai Ke Za Zhi. 2019. PMID: 31054552 Chinese. - Subtotal colectomy and ileorectal anastomosis for slow transit constipation: clinical follow-up at median of 15 years.
Patton V, Balakrishnan V, Pieri C, Doherty P, Phan-Thien KC, King DW, Lubowski DZ. Patton V, et al. Tech Coloproctol. 2020 Feb;24(2):173-179. doi: 10.1007/s10151-019-02140-5. Epub 2020 Jan 6. Tech Coloproctol. 2020. PMID: 31907721 - Results of colectomy for severe slow transit constipation.
Lubowski DZ, Chen FC, Kennedy ML, King DW. Lubowski DZ, et al. Dis Colon Rectum. 1996 Jan;39(1):23-9. doi: 10.1007/BF02048263. Dis Colon Rectum. 1996. PMID: 8601352 Review.
Cited by
- Comparing the short-term clinical outcomes and therapeutic effects of different colectomies in patients with refractory slow-transit constipation in eastern countries: a network meta-analysis.
Xue X, Zeng H, Chen D, Zheng B, Liang B, Xu D, Lin S. Xue X, et al. Updates Surg. 2024 Apr;76(2):411-422. doi: 10.1007/s13304-024-01762-1. Epub 2024 Feb 8. Updates Surg. 2024. PMID: 38329678 Review. - Anorectal manovolumetry in the decision making before surgery for slow transit constipation.
Lundin E, Graf W, Karlbom U. Lundin E, et al. Tech Coloproctol. 2007 Sep;11(3):259-65. doi: 10.1007/s10151-007-0361-y. Epub 2007 Aug 3. Tech Coloproctol. 2007. PMID: 17676264 - Sacral neuromodulation for the management of severe constipation: development of a constipation treatment protocol.
Sharma A, Liu B, Waudby P, Duthie GS. Sharma A, et al. Int J Colorectal Dis. 2011 Dec;26(12):1583-7. doi: 10.1007/s00384-011-1257-x. Epub 2011 Jun 30. Int J Colorectal Dis. 2011. PMID: 21717093 Clinical Trial. - Preservation of superior rectal artery in laparoscopically assisted subtotal colectomy with ileorectal anastomosis for slow transit constipation.
Wu CW, Pu TW, Kang JC, Hsiao CW, Chen CY, Hu JM, Lin KH, Lin TC. Wu CW, et al. World J Gastroenterol. 2021 Jun 14;27(22):3121-3129. doi: 10.3748/wjg.v27.i22.3121. World J Gastroenterol. 2021. PMID: 34168413 Free PMC article. - Guidelines for the Diagnosis and Treatment of Chronic Functional Constipation in Korea, 2015 Revised Edition.
Shin JE, Jung HK, Lee TH, Jo Y, Lee H, Song KH, Hong SN, Lim HC, Lee SJ, Chung SS, Lee JS, Rhee PL, Lee KJ, Choi SC, Shin ES; Clinical Management Guideline Group under the Korean Society of Neurogastroenterology and Motility. Shin JE, et al. J Neurogastroenterol Motil. 2016 Jul 30;22(3):383-411. doi: 10.5056/jnm15185. J Neurogastroenterol Motil. 2016. PMID: 27226437 Free PMC article. Review.
MeSH terms
LinkOut - more resources
Full Text Sources
Medical