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Il Giornale di Chirurgia

Videolaparo-assisted subtotal colectomy with cecorectal anastomosis in the treatment of chronic slow transit constipation

Articolo Originale, 487 - 490
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Summary: Videolaparo-assisted subtotal colectomy with cecorectal anastomosis in the treatment of chronic slow transit constipation.
G. Conzo, F. Stanzione, S. Celsi, A. Palazzo, C. Della Pietra, G. Candilio, A. Livrea
Mechanical cecorectal anastomosis after subtotal colectomy, in the treatment of slow transit constipation, probably represents the most attractive surgical alternative to total colectomy and ileorectal anastomosis. In fact the operation allows better results in terms of postoperative diarrhoea, fecal incontinence and postoperative adherential syndrome. Literature data have demonstrated the feasibility of the laparoscopic approach with tipically advantages of less invasive surgery respect of parietal integrity,less postoperative pain and ileus, fewer postoperative adhesions, a reduced hospitalitation and finally, a better cosmesis.
The Authors report a case of mechanical end to end cecorectal anastomosis after laparo-assisted subtotal colectomy (by four trocars) preserving superior rectal and ilecolic vessels, for the treatment of slow transit constipation in a 20 years old male patient .The reported operative approach which links tipical laparoscopic advantages to a more “safety” and “accurate” extracorporeal mechanical anastomosis.

Versione italiana
Riassunto: Colectomia subtotale videolaparoscopica con anastomosi ciecorettale nel trattamento della stipsi da rallentato transito.
G. Conzo, F. Stanzione, S. Celsi, A. Palazzo, C. Della Pietra, G. Candilio, A. Livrea
Nel trattamento chirurgico della stipsi cronica da rallentato transito la colectomia subtotale con anastomosi ciecorettale rappresenta una valida alternativa alla colectomia totale con anastomosi ileorettale. L’intervento offre migliori risultati in termini di diarrea postoperatoria, incontinenza fecale e sindrome aderenziale postoperatoria. I dati della letteratura hanno dimostrato i vantaggi dell’approccio laparoscopico in termini di minor dolore e ileo postoperatorio, minori aderenze, ridotta ospedalizzazione e infine una migliore cosmesi.
Gli Autori descrivono un caso di colectomia subtotale videolaparoscopica (4 trocar) con anastomosi termino-terminale, con preservazione dei vasi rettali superiori ed ileocolici, per il trattamento della stipsi cronica da rallentato transito in un paziente di 20 anni, riportando i tipici vantaggi della laparoscopia associati ad una più “sicura” e “accurata” anastomosi extracorporea.

Vol XL (No. 4) 2019 July-August

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  1. Videolaparo-assisted subtotal colectomy with cecorectal anastomosis in the treatment of chronic slow transit constipation
    Conzo G., Stanzione F., Celsi S., Palazzo A., Della Pietra C., Candilio G., Livrea A.
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