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Long-term functional outcome after tubular laparoscopic sigmoid resection for diverticular disease
PURPOSE: Sigmoid resection for diverticular disease is a frequent surgical procedure in the Western world. However, long-term bowel function after sigmoid resection has been poorly described in the literature. This study aims to assess the long-term bowel function after tubular sigmoid resection wit...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9842559/ https://www.ncbi.nlm.nih.gov/pubmed/36645511 http://dx.doi.org/10.1007/s00384-023-04311-1 |
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author | Abdalla, Thaer S. A. Zimmermann, Markus Weisheit, Lena Thomaschewski, Michael Deichmann, Steffen Nolde, Jan Keck, Tobias Benecke, Claudia |
author_facet | Abdalla, Thaer S. A. Zimmermann, Markus Weisheit, Lena Thomaschewski, Michael Deichmann, Steffen Nolde, Jan Keck, Tobias Benecke, Claudia |
author_sort | Abdalla, Thaer S. A. |
collection | PubMed |
description | PURPOSE: Sigmoid resection for diverticular disease is a frequent surgical procedure in the Western world. However, long-term bowel function after sigmoid resection has been poorly described in the literature. This study aims to assess the long-term bowel function after tubular sigmoid resection with preservation of inferior mesenteric artery (IMA) for diverticular disease. METHODS: We retrospectively identified patients who underwent sigmoid resection for diverticular disease between 2002 and 2012 at a tertiary referral center in northern Germany. Using well-validated questionnaires, bowel function was assessed for fecal urgency, incontinence, and obstructed defecation. The presence of bowel dysfunction was compared to baseline characteristics and perioperative outcome. RESULTS: Two hundred and thirty-eight patients with a mean age of 59.2 ± 10 years responded to our survey. The follow-up was conducted 117 ± 32 months after surgery. At follow-up, 44 patients (18.5%) had minor LARS (LARS 21–29) and 35 (15.1%) major LARS (LARS ≥ 30–42), 35 patients had moderate-severe incontinence (CCIS ≥ 7), and 2 patients (1%) had overt obstipation (CCOS ≥ 15). The multivariate analysis showed that female gender was the only prognostic factor for long-term incontinence (CCIS ≥ 7), and ASA score was the only preoperative prognostic factor for the presence of major LARS at follow-up. CONCLUSION: Sigmoid resection for diverticular disease can be associated with long-term bowel dysfunction, even with tubular dissection and preservation of IMA. These findings suggest intercolonic mechanisms of developing symptoms of bowel dysfunction after disruption of the colorectal continuity that are so far summarized as “sigmoidectomy syndrome.” |
format | Online Article Text |
id | pubmed-9842559 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-98425592023-01-18 Long-term functional outcome after tubular laparoscopic sigmoid resection for diverticular disease Abdalla, Thaer S. A. Zimmermann, Markus Weisheit, Lena Thomaschewski, Michael Deichmann, Steffen Nolde, Jan Keck, Tobias Benecke, Claudia Int J Colorectal Dis Research PURPOSE: Sigmoid resection for diverticular disease is a frequent surgical procedure in the Western world. However, long-term bowel function after sigmoid resection has been poorly described in the literature. This study aims to assess the long-term bowel function after tubular sigmoid resection with preservation of inferior mesenteric artery (IMA) for diverticular disease. METHODS: We retrospectively identified patients who underwent sigmoid resection for diverticular disease between 2002 and 2012 at a tertiary referral center in northern Germany. Using well-validated questionnaires, bowel function was assessed for fecal urgency, incontinence, and obstructed defecation. The presence of bowel dysfunction was compared to baseline characteristics and perioperative outcome. RESULTS: Two hundred and thirty-eight patients with a mean age of 59.2 ± 10 years responded to our survey. The follow-up was conducted 117 ± 32 months after surgery. At follow-up, 44 patients (18.5%) had minor LARS (LARS 21–29) and 35 (15.1%) major LARS (LARS ≥ 30–42), 35 patients had moderate-severe incontinence (CCIS ≥ 7), and 2 patients (1%) had overt obstipation (CCOS ≥ 15). The multivariate analysis showed that female gender was the only prognostic factor for long-term incontinence (CCIS ≥ 7), and ASA score was the only preoperative prognostic factor for the presence of major LARS at follow-up. CONCLUSION: Sigmoid resection for diverticular disease can be associated with long-term bowel dysfunction, even with tubular dissection and preservation of IMA. These findings suggest intercolonic mechanisms of developing symptoms of bowel dysfunction after disruption of the colorectal continuity that are so far summarized as “sigmoidectomy syndrome.” Springer Berlin Heidelberg 2023-01-16 2023 /pmc/articles/PMC9842559/ /pubmed/36645511 http://dx.doi.org/10.1007/s00384-023-04311-1 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Research Abdalla, Thaer S. A. Zimmermann, Markus Weisheit, Lena Thomaschewski, Michael Deichmann, Steffen Nolde, Jan Keck, Tobias Benecke, Claudia Long-term functional outcome after tubular laparoscopic sigmoid resection for diverticular disease |
title | Long-term functional outcome after tubular laparoscopic sigmoid resection for diverticular disease |
title_full | Long-term functional outcome after tubular laparoscopic sigmoid resection for diverticular disease |
title_fullStr | Long-term functional outcome after tubular laparoscopic sigmoid resection for diverticular disease |
title_full_unstemmed | Long-term functional outcome after tubular laparoscopic sigmoid resection for diverticular disease |
title_short | Long-term functional outcome after tubular laparoscopic sigmoid resection for diverticular disease |
title_sort | long-term functional outcome after tubular laparoscopic sigmoid resection for diverticular disease |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9842559/ https://www.ncbi.nlm.nih.gov/pubmed/36645511 http://dx.doi.org/10.1007/s00384-023-04311-1 |
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