Our Summary

This research paper looks at the results of a specific surgical treatment for patients suffering from long-term, unexplained constipation accompanied by an abnormally large rectum and accidental bowel leakage. The researchers analyzed eight cases from 2014 to 2016, where patients underwent a surgical procedure that involved removing a portion of the large intestine, specifically the sigmoid colon and creating a new opening (stoma) using the appendix. The patients ranged from 5 to 19 years old, and all had been dealing with constipation for 4 to 15 years. They had all tried various laxatives without success and experienced social issues due to their condition, including half of the patients who had autism. The surgery was considered when laxatives weren’t working, patients refused to continue with rectal enemas, or there was a fear of continued accidental bowel leakage. The results were positive, with all patients having regular bowel movements without accidents post-surgery. The study concludes that this surgical procedure can be beneficial for certain patients suffering from this specific type of chronic constipation.

FAQs

  1. What is the purpose of a sigmoidectomy and appendicostomy in patients with chronic idiopathic constipation complicated by megarectosigmoid and fecal incontinence?
  2. What were the main indications for surgery in the patients discussed in the study?
  3. What were the outcomes for patients who underwent a sigmoidectomy and appendicostomy for chronic idiopathic constipation and fecal incontinence?

Doctor’s Tip

A helpful tip a doctor might tell a patient about sigmoidectomy is to follow post-operative instructions carefully, including maintaining a healthy diet and staying hydrated to promote proper healing and bowel function. It is also important to communicate any concerns or changes in symptoms to your healthcare provider promptly.

Suitable For

Patients who are typically recommended sigmoidectomy are those with chronic idiopathic constipation complicated by megarectosigmoid and fecal incontinence. These patients may have tried multiple laxatives without success, have severe social problems related to their condition, and may have other underlying conditions such as autism. They may also have a fear of continued fecal incontinence and may have difficulty with rectal enemas. Ultimately, patients who have not responded well to conservative medical treatments and who have significant functional impairment may be candidates for sigmoidectomy.

Timeline

Before sigmoidectomy:

  • Patients experience chronic idiopathic constipation for 4-15 years
  • Patients receive multiple laxatives, mainly polyethylene glycol
  • Patients have severe social problems and four patients have autism
  • Patients undergo unsuccessful laxative trials and refuse rectal enemas
  • Patients have social fear of continued fecal incontinence

After sigmoidectomy:

  • Patients undergo primary sigmoidectomy and appendicostomy
  • Age at operation ranges from 5-19 years
  • All patients have daily bowel movements without fecal accidents
  • All patients experience great benefit from the surgery
  • Indications for surgery include unsuccessful laxative trials and refusal of rectal enemas or both

What to Ask Your Doctor

  1. What is the success rate of sigmoidectomy in patients with chronic idiopathic constipation and fecal incontinence?
  2. What are the potential risks and complications associated with sigmoidectomy and appendicostomy?
  3. How long is the recovery period after sigmoidectomy?
  4. Will I still need to take laxatives or other medications after the surgery?
  5. How will my bowel movements be affected after sigmoidectomy?
  6. Are there any dietary or lifestyle changes I should make post-surgery?
  7. Will I need any additional follow-up care or monitoring after the procedure?
  8. What is the long-term outlook for patients who undergo sigmoidectomy for chronic idiopathic constipation and fecal incontinence?

Reference

Authors: De La Torre L, Cogley K, Calisto J, Nace G, Correa C. Journal: Pediatr Surg Int. 2016 Aug;32(8):767-72. doi: 10.1007/s00383-016-3913-2. Epub 2016 Jul 2. PMID: 27372298