Our Summary

A 47-year-old man with no known previous health issues was taken to Sanno Hospital because he had been suffering from constipation and stomach pain for over 5 years. When doctors took images of his abdomen, they found that part of his colon (the large intestine) was swollen. His condition, known as chronic idiopathic colonic pseudo-obstruction, was not due to any physical blockage. His symptoms couldn’t be controlled with medication, so he had to undergo surgery. The doctors performed a laparoscopic subtotal colectomy, which is a procedure to remove part of the colon, and he didn’t experience any complications. After the surgery, his constipation improved and he was able to go to the bathroom 2-3 times a day without needing medication. When doctors examined the removed part of the colon, they found fewer nerve cells than normal, which is consistent with his diagnosis.

FAQs

  1. What is chronic idiopathic colonic pseudo-obstruction and how is it diagnosed?
  2. What is a laparoscopic subtotal colectomy and why was it performed on the patient?
  3. What were the results of the patient’s surgery and how did it impact his symptoms?

Doctor’s Tip

One helpful tip a doctor might tell a patient about laparoscopic colectomy is to follow post-operative care instructions carefully, including proper wound care and gradually reintroducing solid foods into their diet. It is important to stay hydrated and to avoid heavy lifting or strenuous activities for a certain period of time to ensure proper healing. Additionally, attending follow-up appointments with the surgeon and adhering to any prescribed medications or therapies is essential for a successful recovery.

Suitable For

Patients who are typically recommended for laparoscopic colectomy include those with conditions such as chronic idiopathic colonic pseudo-obstruction, inflammatory bowel disease, colon cancer, diverticulitis, and severe constipation that does not respond to medication. These patients may experience symptoms such as abdominal pain, bloating, constipation, diarrhea, and weight loss. Laparoscopic colectomy is often recommended as a minimally invasive surgical option that can help improve symptoms and quality of life for these patients.

Timeline

Before laparoscopic colectomy:

  • Patient experiences constipation and abdominal pain for more than 5 years
  • Abdominal X-ray and CT scan show an enlarged ascending colon without mechanical obstruction
  • Diagnosed with chronic idiopathic colonic pseudo-obstruction
  • Symptoms resistant to medication, requiring surgical treatment

After laparoscopic colectomy:

  • Laparoscopic subtotal colectomy performed without complications
  • Constipation relieved, patient defecates 2-3 times a day without medication
  • Pathological specimens show decreased Meissner’s plexus and Auerbach’s plexus, fewer ganglion cells consistent with chronic idiopathic intestinal pseudo-obstruction
  • Patient experiences relief from symptoms and improved bowel function.

What to Ask Your Doctor

  1. What is laparoscopic colectomy and how is it different from traditional open surgery?
  2. What are the potential risks and complications associated with laparoscopic colectomy?
  3. What is the recovery process like after laparoscopic colectomy?
  4. How soon after the surgery can I expect to resume normal activities?
  5. Will I need any special dietary or lifestyle changes after the surgery?
  6. What follow-up care will be required after the surgery?
  7. Are there any long-term effects or complications I should be aware of?
  8. How successful is laparoscopic colectomy in treating chronic idiopathic colonic pseudo-obstruction?
  9. Are there any alternative treatment options I should consider?
  10. How experienced are you in performing laparoscopic colectomy procedures?

Reference

Authors: Ozawa T, Ishihara S, Okada Y, Ohno K, Yagi T, Fukushima Y, Shimada R, Hayama T, Tsuchiya T, Nozawa K, Matsuda K, Matsuoka R, Mori I, Fukuzawa R, Takiyama A, Takao Y, Shimizu N, Kikuchi K, Hashiguchi Y. Journal: Asian J Endosc Surg. 2019 Oct;12(4):469-472. doi: 10.1111/ases.12682. Epub 2019 Jan 7. PMID: 30618177