HEFT Repository

Surgery for constipation: systematic review and practice recommendations: Results I: Colonic resection.

Knowles, C H and Grossi, U and Chapman, M and Mason, J (2017) Surgery for constipation: systematic review and practice recommendations: Results I: Colonic resection. Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland, 19 Sup. pp. 17-36. ISSN 1463-1318. This article is available to all HEFT staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their HEFT Athens login IDs

Full text not available from this repository.
Official URL: http://onlinelibrary.wiley.com/doi/10.1111/codi.13...

Abstract

AIM

To assess the outcomes of colectomy in adults with chronic constipation (CC).

METHOD

Standardised methods and reporting of benefits and harms were used for all CapaCiTY reviews that closely adhered to PRISMA 2016 guidance. Main conclusions were presented as summary evidence statements (SES) with a summative Oxford Centre for Evidence-Based Medicine (2009) level.

RESULTS

Forty articles were identified, providing data on outcomes in 2045 patients. Evidence was derived almost exclusively from observational studies, the majority of which concerned colectomy and ileorectal anastomosis (CIRA) rather than other procedural variations. Average length of stay (LOS) ranged between 7-15 days. Although inconsistent, laparoscopic surgery may be associated with longer mean operating times (210 vs 167 min) and modest decreases in LOS (10-8 days). Complications occurred in approximately 24% of patients. Six (0.4%) procedure-related deaths were observed. Recurrent episodes of small bowel obstruction occurred in about 15% (95%CI: 10-21%) of patients in the long-term, with significant burden of re-hospitalisation and frequent recourse to surgery. Most patients reported a satisfactory or good outcome after colectomy but negative long-term functional outcomes persist in a minority of patients. The influence of resection extent, anastomotic configuration and method of access on complication rates remains uncertain. Available evidence weakly supports selection of patients with an isolated slow-transit phenotype.

CONCLUSION

Colectomy for CC may benefit some patients but at the cost of substantial short- and long-term morbidity. Current evidence is insufficient to guide patient or procedural selection.

Item Type: Article
Additional Information: This article is available to all HEFT staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their HEFT Athens login IDs
Subjects: WI Digestive system. Gastroenterology
WO Surgery
Divisions: Planned IP Care > General Surgery
Related URLs:
Depositing User: Mrs Yolande Brookes
Date Deposited: 23 Nov 2017 16:02
Last Modified: 23 Nov 2017 16:02
URI: http://www.repository.heartofengland.nhs.uk/id/eprint/1499

Actions (login required)

View Item View Item