ROLE OF SEGMENTAL COLONIC TRANSIT-TIME STUDIES TO SELECT PATIENTS WITH SLOW TRANSIT CONSTIPATION FOR PARTIAL LEFT-SIDED OR SUBTOTAL COLECTOMY

This prospective study investigated the value of segmental colonic tra nsit time studies in the surgical treatment of slow transit constipati on. Overall, 346 patients with chronic constipation were analysed; slo w transit constipation was diagnosed in 86 (25 per cent). Based on the results of segmental colonic transit time studies, 18 patients underw ent partial left-sided colectomy and 24 subtotal colectomy. Recurrent constipation was seen in three of 18 patients and seven of 24 respecti vely. Severe abdominal discomfort was noted in six of 18 and 15 of 24 respectively. Disabling diarrhoea and faecal incontinence developed in two of 14 and five of 20 patients with and anastomosis respectively. Although these results indicate that segmental colonic transit time st udies are useful in selecting patients with slow transit constipation for partial left-sided or subtotal colectomy, both procedures should b e performed with prudence.