TITLE:
Feasibility of the Laparoscopic Total Colectomy with Ileal j-Pouch-Rectal Anastomosis in the Treatment of Chronic Constipation Refractory to Medical Therapy: Observations about a Case Report
AUTHORS:
Alfredo Allaria, Vincenzo Napolitano, Maria Chiara Bondanese, Francesco Moccia, Marco Cimmino, Beniamino Pascotto, Francesco Orlando, Landino Fei
KEYWORDS:
Total Colectomy; Chronic Constipation; Laparoscopy; Ileal j-Pouch
JOURNAL NAME:
Surgical Science,
Vol.4 No.9,
August
20,
2013
ABSTRACT: In October 2012, a 29-year-old woman
affected by chronic constipation underwent surgery for a laparoscopic total
colectomy with ileal j-pouch-rectal anastomosis. After a precise instrumental
work-up, the patient was selected as a potential candidate for the surgical
treatment after failing to respond to all other medical treatment. During the
first three months following the surgery, the patient recorded 3 - 4 daily evacuations of soft stool.
After the third month, the number of evacuations stabilised at 2 -3
a day, with formed stool, and no mention of incontinence or
abdominal pain. Although the laparoscopic total colectomy with ileorectal
anastomosis (TC with IRA) and the laparoscopically assisted subtotal colectomy
with cecorectal anastomosis (SC with CRA) are the most frequently practiced
procedures in the surgical treatment of chronic constipation, the laparoscopic
colectomy with ileal j-pouch has shown in our experience to be a feasible and
effective procedure, with similar results to the two aforementioned procedures
in terms of morbidity, mortality and quality of life. In fact, like the first
two, the total colectomy with ileal j-pouch has demonstrated the advantages of
laparoscopic surgery: low invasiveness, less post-operative pain or ileus,
respect of parietal integrity, reduced hospitalization and, lastly, a better
cosmesis.