SURGICAL TREATMENT METHOD FOR CHRONIC COPROSTASIS IN DECOMPENSATED DOLICHOSIGMA SHAPED
Abstract
Objective: To enhance outcomes in endovideosurgical treatment for patients with chronic coprostasis associated with decompensated dolichosigma. Methods: Patients with chronic constipation treated at City Multispecialty Hospital No. 2 in Astana from 2019 to 2023 underwent laparoscopic left-sided hemicolectomy using a specialized technique for decompensated dolichosigma and chronic coprostasis. Of the 28 patients admitted during this period, 25 received surgery using the new technique, while three urgently underwent surgery for acute intestinal obstruction. Patients in the new technique group had a shorter hospital stay (7-8 days) compared to those with traditional sigmoid colon resection (12.0 ± 1.1 days). Comprehensive assessments included clinical and laboratory studies, instrumental examinations, and microbiological investigations. Laparoscopic equipment was used for all surgeries. Results: The new surgical method led to an average hospital stay of 7-8 days, shorter than the traditional surgery group's 12.0 ± 1.1 days, with no postoperative complications. Comprehensive rehabilitation after surgery was followed by 6 to 12 months of medical monitoring. Colonic function fully recovered in the new method group, marked by regular, well-formed stools without laxative use. Patients reported an improved quality of life and a return to work activities during follow-up. Conclusion: The enhanced endovideosurgical approach for managing coprostasis in patients with decompensated dolichosigma substantially diminishes the occurrence of procedure-associated complications, leading to a reduction in the duration of postoperative recovery and temporary work incapacity for affected individuals.
Keywords:
chronic coprostasis, dolichosigma, laparoscopic left-sided hemicolectomy method, selection criteria.References
1. Privorotsky VF, Luppova NE. Modern approaches to the treatment of functional constipation in children. RJGGK. 2009;19(1):59-65.
2. Rao SS, Rattanakovit K, Patcharatrakul T. Diagnosis and management of chronic constipation in adults. Nat Rev Gastroenterol Hepatol. 2016;13(5):295-305. https://doi.org/10.1038/nrgastro.2016.53
3. Koppen IJ, Di Lorenzo C, Saps M, et al. Childhood constipation: finally something is moving! Expert Rev Gastroenterol Hepatol. 2016;10(1):141-155. https://doi.org/10.1586/17474124.2016.1098533
4. Vazquez Roque M, Bouras EP. Epidemiology and management of chronic constipation in elderly patients. Clin Interv Aging. 2015;10:919-930. Published 2015 Jun 2. https://doi.org/10.2147/CIA.S54304
5. Rustemova KR, Kozhahmetov SK, Aitmoldin BA. Minimally invasive methods of surgical treatment of diseases of the colon. Astana medicinalyk zhurnaly. 2019; 4(102):140-146.
6. Aitmoldin B, Rustemova K, Tsoi O, Dzheksenova A, Zhylkaidar S. Surgical metod for the treatment of chronic coprostasis in patients with dolichosigma. Astana medicinalyk zhurnaly. 2023;116: 46-51. https://doi.org/10.54500/2790 1203-2023-116-46-51
7. Sharma A, Rao S. Constipation: Pathophysiology and Current Therapeutic Approaches. Handb Exp Pharmacol. 2017;239:59-74. https://doi.org/10.1007/164_2016_111
8. Scott SM, Simrén M, Farmer AD, Dinning PG, Carrington EV, Benninga MA, et al. Chronic constipation in adults: Contemporary perspectives and clinical challenges. 1: Epidemiology, diagnosis, clinical associations, pathophysiology and investigation. Neurogastroenterol Motil. 2021;33(6):e14050. https://doi.org/10.1111/nmo.14050
9. Mahon M, Khlevner J. Hirschsprung Disease. Pediatr Rev. 2021;42(12):714-716. https://doi.org/10.1542/pir.2020-004912
10. Wang XJ, Camilleri M. Chronic Megacolon Presenting in Adolescents or Adults: Clinical Manifestations, Diagnosis,and Genetic Associations. Dig Dis Sci. 2019;64(10):2750-2756. https://doi.org/10.1007/s10620-019-05605-7
11. Джавадов Э.А., Курбанов Ф.С., Ткаченко Ю.Н. Долихоколон как причина хронического запора. Хирургия. Журнал им. Н.И. Пирогова. 2010;7:25‑27. [Dzhavadov ÉA, Kurbanov FS, Tkachenko IuN. Dolichocolon as a reason of chronic constipation. Pirogov Russian Journal of Surgery = Khirurgiya. Zurnal im. N.I. Pirogova. 2010;7:25‑27. (In Russ.).]
12. Bove A, Pucciani F, Bellini M, Battaglia E, Bocchini R, Altomare DF, et al. Consensus statement AIGO/SICCR: diagnosis and treatment of chronic constipation and obstructed defecation (part I: diagnosis). World J Gastroenterol. 2012;18(14) :1555-1564. https://doi.org/10.3748/wjg.v18.i14.1555
13. Aziz I, Whitehead WE, Palsson OS, Törnblom H, Simrén M. An approach to the diagnosis and management of Rome IV functional disorders of chronic constipation. Expert Rev Gastroenterol Hepatol. 2020;14(1):39-46. https://doi.org/10.1080/17474124.2020.1708718
14. Плотникова Е.Ю. Современные представления о запоре. Лечащий врач. 2015;8:7–17.
15. Парфенов А.И. Три варианта патогенеза и терапии хронического запора. Экспериментальная и клиническая гастроэнтерология. 2012;3:7-19. [Parfenov AI. Three variants of pathogenesis and therapy of chronic constipation. Eksp Klin Gastroenterol. 2012;(3):7-19 (In Russ.).]
16. Muto M, Matsufuji H, Taguchi T, Tomomasa T, Nio M, Tamai H, et al. Japanese clinical practice guidelines for allied disorders of Hirschsprung's disease, 2017. Pediatr Int. 2018;60(5):400-410. https://doi.org/10.1111/ped.13559
17. Bharucha AE, Lacy BE. Mechanisms, Evaluation, and Management of Chronic Constipation. Gastroenterology. 2020;158(5):1232-1249.e3. https://doi.org/10.1053/j.gastro.2019.12.034
18. Bove A, Bellini M, Battaglia E, Bocchini R, Gambaccini D, Bove V, et al. Consensus statement AIGO/SICCR diagnosis and treatment of chronic constipation and obstructed defecation (part II: treatment). World J Gastroenterol. 2012;18(36): 4994-5013. https://doi.org/10.3748/wjg.v18.i36.4994
19. Klein M, Varga I. Hirschsprung's Disease-Recent Understanding of Embryonic Aspects, Etiopathogenesis and Future Treatment Avenues. Medicina (Kaunas). 2020;56(11):611. https://doi.org/10.3390/medicina56110611
20. Sui JK, Zhang W. [Etiological analysis and surgical method selection of adult megacolon]. Zhonghua Wei Chang Wai Ke Za Zhi. 2021 Dec 25;24(12):1054-1057. Chinese. https://doi.org/10.3760/cma.j.cn441530-20211103-00445
21. Bimurzaeyeva A, Rustemova K, Aitmoldin A. Laparoscopic methods of surgical treatment of colon diseases. 26 th Congress EAES. 15-18 june 2018. Netherlands: Amsterdam; 2018. (oral report).
22. Pare P. The approach to diagnosis and treatment of chronic constipation: suggestions for a general practitioner. Can J Gastroenterol. 2011;25(Suppl B):36B-40B. https://doi.org/10.1155/2011/368189
