Evaluation of surgical effectiveness for slow transit constipation in functional outcomes and quality of life_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

TIAN Yue , ZHANG Yong , ZHENG Huichao , WANG Li , YE Jingwang , LI Fan , LI Chunxue , ZHANG Anping , LIU Baohua ,  TONG Weidong

Department of General Surgery, Gastric Colorectal Division, Daping Hospital, Army Medical University, Chongqing 400042, R. P. China;

Corresponding author：

TONG Weidong, Email: vdtong@163.com

Keywords：

slow transit constipation; functional outcomes; quality of life

DOI：

10.7507/1007-9424.201904015

Video：

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Objective To evaluate the functional outcomes and quality of life in patients with surgery for slow transit constipation (STC).Methods From March 2013 to July 2017, 29 patients undergoing total or subtotal colectomy for STC in our department were analyzed prospectively. Their preoperative and postoperative 1-year follow-up details were analyzed. Evacuation function of all patients was assessed by bowel movements, abdominal pain, bloating, straining, laxative, enema use and the Wexner constipation scales. Quality of life was evaluated by the Gastrointestinal Quality of Life Index (GIQLI) and the short-form (SF)-36 survey.Results A high number of patients (93.1%, 27/29) in STC stated that surgery received benefits to their health. Compared with that before operation, the number of bowel movements per week during a 1-year follow-up increased significantly (31.6±19.9 vs. 1.21±0.6, P<0.05). Significant trends toward improvement of bloating, straining, laxative and enema use were noted 1-year following surgery (P<0.05). The Wexner constipation scales scores during a 1-year follow-up decreased significantly (5.69±3.4 vs. 20.34±0.6, P<0.05). The GIQLI scores during a 1-year follow-up increased significantly (120.7±20.4 vs. 78.6±17.3, P<0.05). Moreover, results of SF-36 showed significant improvements in 7 spheres (role physical, role emotional, physical pain, vitality, mental health, social function and general health) during a 1-year follow-up compared with those before operation (P<0.05).Conclusion Total or subtotal colectomy for STC did not only alleviate constipation symptoms dramatically, but also received significant improvements in the patients’ quality of life.

Citation： TIAN Yue, ZHANG Yong, ZHENG Huichao, WANG Li, YE Jingwang, LI Fan, LI Chunxue, ZHANG Anping, LIU Baohua, TONG Weidong. Evaluation of surgical effectiveness for slow transit constipation in functional outcomes and quality of life. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2019, 26(10): 1170-1174. doi: 10.7507/1007-9424.201904015 Copy

1.	Suares NC, Ford AC. Prevalence of, and risk factors for, chronic idiopathic constipation in the community: systematic review and meta-analysis. Am J Gastroenterol, 2011, 106(9): 1582-1591; quiz 1581, 1592.
2.	Chu H, Zhong L, Li H, et al. Epidemiology characteristics of constipation for general population, pediatric population, and elderly population in china. Gastroenterol Res Pract, 2014, 2014: 532734.
3.	Frattini JC, Nogueras JJ. Slow transit constipation: a review of a colonic functional disorder. Clin Colon Rectal Surg, 2008, 21(2): 146-152.
4.	Tillou J, Poylin V. Functional disorders: slow-transit constipation. Clin Colon Rectal Surg, 2017, 30(1): 76-86.
5.	Marples G. Diagnosis and management of slow transit constipation in adults. Nurs Stand, 2011, 26(8): 41-48.
6.	魏东. 慢传输型便秘外科手术方法的治疗进展. 中华胃肠外科杂志, 2018, 21(3): 357-360.
7.	刘宝华. 结肠慢传输性便秘外科治疗国内外进展. 中国普外基础与临床杂志, 2007, 14(6): 630-631.
8.	McCoy JA, Beck DE. Surgical management of colonic inertia. Clin Colon Rectal Surg, 2012, 25(1): 20-23.
9.	Zutshi M, Hull TL, Trzcinski R, et al. Surgery for slow transit constipation: are we helping patients? Int J Colorectal Dis, 2007, 22(3): 265-269.
10.	Ripetti V, Caputo D, Greco S, et al. Is total colectomy the right choice in intractable slow-transit constipation? Surgery, 2006, 140(3): 435-440.
11.	Riss S, Herbst F, Birsan T, et al. Postoperative course and long term follow up after colectomy for slow transit constipation—is surgery an appropriate approach? Colorectal Dis, 2009, 11(3): 302-307.
12.	张晓微, 马振南, 孙威, 等. 结肠次全切除回肠乙状结肠吻合术治疗慢传输型便秘的临床疗效. 中国普外基础与临床杂志, 2018, 25(12): 67-73.
13.	Drossman DA, Hasler WL. Rome Ⅳ-functional GI disorders: disorders of gut-brain interaction. Gastroenterology, 2016, 150(6): 1257-1261.
14.	Agachan F, Chen T, Pfeifer J, et al. A constipation scoring system to simplify evaluation and management of constipated patients. Dis Colon Rectum, 1996, 39(6): 681-685.
15.	Eypasch E, Williams JI, Wood-Dauphinee S, et al. Gastrointestinal Quality of Life Index: development, validation and application of a new instrument. Br J Surg, 1995, 82(2): 216-222.
16.	Zuniga MA, Carrillo-Jimenez GT, Fos PJ, et al. Evaluation of health status using Survey SF-36: preliminary results in Mexico. Salud Publica Mex, 1999, 41(2): 110-108.
17.	Marchesi F, Sarli L, Percalli L, et al. Subtotal colectomy with antiperistaltic cecorectal anastomosis in the treatment of slow-transit constipation: long-term impact on quality of life. World J Surg, 2007, 31(8): 1658-1664.
18.	Sohn G, Yu CS, Kim CW, et al. Surgical outcomes after total colectomy with ileorectal anastomosis in patients with medically intractable slow transit constipation. J Korean Soc Coloproctol, 2011, 27(4): 180-187.
19.	Reshef A, Alves-Ferreira P, Zutshi M, et al. Colectomy for slow transit constipation: effective for patients with coexistent obstructed defecation. Int J Colorectal Dis, 2013, 28(6): 841-847.
20.	Knowles CH, Scott M, Lunniss PJ. Outcome of colectomy for slow transit constipation. Ann Surg, 1999, 230(5): 627-638.
21.	Li F, Fu T, Tong W, et al. Effect of different surgical options on curative effect, nutrition, and health status of patients with slow transit constipation. Int J Colorectal Dis, 2014, 29(12): 1551-1556.
22.	Wei D, Cai J, Yang Y, et al. A prospective comparison of short term results and functional recovery after laparoscopic subtotal colectomy and antiperistaltic cecorectal anastomosis with short colonic reservoir vs. long colonic reservoir. BMC Gastroenterol, 2015, 15: 30.
23.	FitzHarris GP, Garcia-Aguilar J, Parker SC, et al. Quality of life after subtotal colectomy for slow-transit constipation: both quality and quantity count. Dis Colon Rectum, 2003, 46(4): 433-440.
24.	Vergara-Fernandez O, Mejía-Ovalle R, Salgado-Nesme N, et al. Functional outcomes and quality of life in patients treated with laparoscopic total colectomy for colonic inertia. Surg today, 2014, 44(1): 34-38.
25.	Thaler K, Dinnewitzer A, Oberwalder M, et al. Quality of life after colectomy for colonic inertia. Tech Coloproctol, 2005, 9(2): 133-137.
26.	Fu T, Zhao S, Li F, et al. Single-incision laparoscopic subtotal colectomy with cecorectal anastomosis for slow transit constipation. Tech Coloproctol, 2016, 20(2): 135-137.
27.	De Marco P, Militello G, Tutino R, et al. The management of the slow transit constipation in the laparoscopic era. G Chir, 2018, 39(5): 297-302.

1. Suares NC, Ford AC. Prevalence of, and risk factors for, chronic idiopathic constipation in the community: systematic review and meta-analysis. Am J Gastroenterol, 2011, 106(9): 1582-1591; quiz 1581, 1592.
2. Chu H, Zhong L, Li H, et al. Epidemiology characteristics of constipation for general population, pediatric population, and elderly population in china. Gastroenterol Res Pract, 2014, 2014: 532734.
3. Frattini JC, Nogueras JJ. Slow transit constipation: a review of a colonic functional disorder. Clin Colon Rectal Surg, 2008, 21(2): 146-152.
4. Tillou J, Poylin V. Functional disorders: slow-transit constipation. Clin Colon Rectal Surg, 2017, 30(1): 76-86.
5. Marples G. Diagnosis and management of slow transit constipation in adults. Nurs Stand, 2011, 26(8): 41-48.
6. 魏东. 慢传输型便秘外科手术方法的治疗进展. 中华胃肠外科杂志, 2018, 21(3): 357-360.
7. 刘宝华. 结肠慢传输性便秘外科治疗国内外进展. 中国普外基础与临床杂志, 2007, 14(6): 630-631.
8. McCoy JA, Beck DE. Surgical management of colonic inertia. Clin Colon Rectal Surg, 2012, 25(1): 20-23.
9. Zutshi M, Hull TL, Trzcinski R, et al. Surgery for slow transit constipation: are we helping patients? Int J Colorectal Dis, 2007, 22(3): 265-269.
10. Ripetti V, Caputo D, Greco S, et al. Is total colectomy the right choice in intractable slow-transit constipation? Surgery, 2006, 140(3): 435-440.
11. Riss S, Herbst F, Birsan T, et al. Postoperative course and long term follow up after colectomy for slow transit constipation—is surgery an appropriate approach? Colorectal Dis, 2009, 11(3): 302-307.
12. 张晓微, 马振南, 孙威, 等. 结肠次全切除回肠乙状结肠吻合术治疗慢传输型便秘的临床疗效. 中国普外基础与临床杂志, 2018, 25(12): 67-73.
13. Drossman DA, Hasler WL. Rome Ⅳ-functional GI disorders: disorders of gut-brain interaction. Gastroenterology, 2016, 150(6): 1257-1261.
14. Agachan F, Chen T, Pfeifer J, et al. A constipation scoring system to simplify evaluation and management of constipated patients. Dis Colon Rectum, 1996, 39(6): 681-685.
15. Eypasch E, Williams JI, Wood-Dauphinee S, et al. Gastrointestinal Quality of Life Index: development, validation and application of a new instrument. Br J Surg, 1995, 82(2): 216-222.
16. Zuniga MA, Carrillo-Jimenez GT, Fos PJ, et al. Evaluation of health status using Survey SF-36: preliminary results in Mexico. Salud Publica Mex, 1999, 41(2): 110-108.
17. Marchesi F, Sarli L, Percalli L, et al. Subtotal colectomy with antiperistaltic cecorectal anastomosis in the treatment of slow-transit constipation: long-term impact on quality of life. World J Surg, 2007, 31(8): 1658-1664.
18. Sohn G, Yu CS, Kim CW, et al. Surgical outcomes after total colectomy with ileorectal anastomosis in patients with medically intractable slow transit constipation. J Korean Soc Coloproctol, 2011, 27(4): 180-187.
19. Reshef A, Alves-Ferreira P, Zutshi M, et al. Colectomy for slow transit constipation: effective for patients with coexistent obstructed defecation. Int J Colorectal Dis, 2013, 28(6): 841-847.
20. Knowles CH, Scott M, Lunniss PJ. Outcome of colectomy for slow transit constipation. Ann Surg, 1999, 230(5): 627-638.
21. Li F, Fu T, Tong W, et al. Effect of different surgical options on curative effect, nutrition, and health status of patients with slow transit constipation. Int J Colorectal Dis, 2014, 29(12): 1551-1556.
22. Wei D, Cai J, Yang Y, et al. A prospective comparison of short term results and functional recovery after laparoscopic subtotal colectomy and antiperistaltic cecorectal anastomosis with short colonic reservoir vs. long colonic reservoir. BMC Gastroenterol, 2015, 15: 30.
23. FitzHarris GP, Garcia-Aguilar J, Parker SC, et al. Quality of life after subtotal colectomy for slow-transit constipation: both quality and quantity count. Dis Colon Rectum, 2003, 46(4): 433-440.
24. Vergara-Fernandez O, Mejía-Ovalle R, Salgado-Nesme N, et al. Functional outcomes and quality of life in patients treated with laparoscopic total colectomy for colonic inertia. Surg today, 2014, 44(1): 34-38.
25. Thaler K, Dinnewitzer A, Oberwalder M, et al. Quality of life after colectomy for colonic inertia. Tech Coloproctol, 2005, 9(2): 133-137.
26. Fu T, Zhao S, Li F, et al. Single-incision laparoscopic subtotal colectomy with cecorectal anastomosis for slow transit constipation. Tech Coloproctol, 2016, 20(2): 135-137.
27. De Marco P, Militello G, Tutino R, et al. The management of the slow transit constipation in the laparoscopic era. G Chir, 2018, 39(5): 297-302.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Evaluation of surgical effectiveness for slow transit constipation in functional outcomes and quality of life

Abstract Full text Figures/Tables Video References Cited by

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