[Efficacy and safety of combined use of subtotal colectomy and modified Duhamel procedure in the surgical treatment of severe functional constipation]

OBJECTIVE

To explore the satisfactory surgical procedure for severe functional constipation (SFC).

METHODS

The data of 50 SFC patients, undergone subtotal colectomy and modified Duhamel procedure from Sep. 2000 to Apr. 2005, were analyzed retrospectively. Gastrointestinal quality of life (GIQOL) of these patients were also evaluated.

RESULTS

All the 50 patients failed to respond to conservative treatment and accepted subtotal colectomy and modified Duhamel procedure after finding pathological changes by the examination of colonoscopy, colon transit time (CTT) and dynamic proctography (DPG). Twenty-seven out of 50 cases (54%) showed colonic muscular atrophy and 29 out of 50 cases (58%) showed decreased ganglion cells in myenteric plexuses of colon. The mean follow-up time after surgical treatment was (2.4+/-1.2) years. GIQOL and constipation index improved dramatically after operations. Forty-four out of 50 patients (88%) were satisfied with their postoperative evacuation. Nine patients complained minor abdominal pain,3 patients diarrhea and 2 patients recurrence of constipation, who were healed by the use of bulk-forming laxatives and GI-mobility drugs.

CONCLUSION

The combination of modified Duhamel procedure and subtotal colectomy is an effective surgical procedure for the treatment of SFC.