COLECTOMY AS TREATMENT FOR CONSTIPATION IN SELECTED PATIENTS

The aim of this study was to conduct a prospective assessment of the r esults of total abdominal colectomy and ileorectal anastomosis (TAC) i n patients with colonic inertia. Overall, 416 patients were evaluated for chronic constipation. Of the patients, 54 (13 per cent) had coloni c inertia, defined as diffuse marker delay during transit study withou t paradoxical puborectalis contraction on cinedefaecography or electro myography. All 54 patients (42 women and 12 men), with a mean age of 4 9 (range 17-78) years, underwent TAC. Preoperative bowel frequency was a mean of one every 8 days, requiring large doses of laxatives, enema s or both. There was no major postoperative morbidity; five patients w ere readmitted due to bowel obstruction, three for successful conserva tive management while the other two required enterolysis. After a mean follow-up of 27 (range 2-51) months these 54 patients reported a mean frequency of spontaneous bowel movements of 3.7 (range 1-10) per day. 'Excellent' or 'good' outcome was reported by 51 patients (94 per cen t). TAC can be performed with acceptable morbidity and 94 per cent of patients will have satisfactory improvement in bowel habit.