Outcome of colectomy for slow transit constipation

Objective To review the outcome data for colectomy performed for patients with slow transit constipation (STC). Background The outcome of surgical intervention in patients with STC is unpredictable. This may be a consequence of the lack of effectiveness of such interventions or may reflect heterogeneity within this group of patients. Methods The authors reviewed the data of all series in the English language that document the outcome of colectomy in greater than or equal to 10 patients in the treatment of STC. Results Thirty-two series fulfilled the entry criteria. There was widespread variability in patient satisfaction rates after colectomy (39% to 100%), reflecting large differences in the incidence of postoperative complications and in long-term functional results. Outcome was dependent on several clinical and pathophysiologic findings and on the type of study, the population studied, and the surgical procedure used. Conclusions It may be possible to predict outcome on the basis of preoperative clinical and pathophysiologic findings. This review suggests a rationale for the selection of patients for colectomy.