Slow transit constipation
Conditions
Interventions
Short Stump Group:None
Long Stump Group:None
Sponsors
Affiliated hangzhou first people's hospital, zhejiang university school of medicine
Eligibility
Sex/Gender
All
Age
18 Years to 75 Years
Inclusion criteria
Inclusion criteria: 1.Fulfilled the diagnostic criteria for functional constipation according to the Rome IV criteria; 2.Aged between 18 and 75 years; 3.Experienced severe constipation symptoms that significantly impaired quality of life and work performance; 4.Demonstrated delayed colonic transit on the colonic transit study, with multiple radiopaque markers retained in the colon at 72 hours and a markedly prolonged total colonic transit time, consistent with slow-transit constipation (STC); 5.Failed to achieve satisfactory symptom relief despite long-term conservative treatment, including dietary modification, laxatives, and prokinetic therapy; 6.Had no evidence of organic colorectal disease; 7.Underwent anorectal physiological evaluation showing no abnormalities of pelvic floor muscle function or anorectal reflexes on anorectal manometry. Defecography excluded outlet obstruction-related disorders, including rectocele, rectal mucosal prolapse, enterocele, puborectalis syndrome, paradoxical pelvic floor contraction, and impaired opening of the anorectal angle during defecation; 8.Had no evidence of congenital megacolon or other neuromuscular disorders affecting intestinal motility; 9.Expressed a clear willingness to undergo surgery and provided written informed consent; 10.Were considered suitable candidates for surgery and postoperative follow-up, with no significant psychiatric disorders or severe systemic diseases that could affect treatment outcomes;
Exclusion criteria
Exclusion criteria: 1.Presence of severe systemic diseases that precluded surgical treatment, including severe coronary artery disease, decompensated heart failure, severe diabetic complications, advanced respiratory disease, cerebrovascular disease, or other conditions associated with an unacceptable operative risk; 2.Evidence of obstructed defecation syndrome (ODS) based on anorectal physiological and imaging assessments, including abnormal findings on defecography (e.g., rectocele, excessive perineal descent, hypertrophy of the puborectalis muscle, or deep puborectalis impression) and/or anorectal manometry demonstrating paradoxical contraction of the external anal sphincter or puborectalis muscle during defecation, inadequate propulsive force, or increased sphincter tone; 3.Presence of structural or organic colorectal diseases, including congenital megacolon, colonic stricture, colonic diverticular disease, diverticulitis, colorectal malignancy, benign colonic tumors, adenomas, polyps, inflammatory bowel disease, or other organic colorectal disorders; 4.Severe psychiatric or psychological disorders, such as major depressive disorder or schizophrenia, or any mental condition that could interfere with treatment compliance or postoperative follow-up; 5.Presence of other gastrointestinal motility disorders, including small-bowel dysmotility, delayed gastric emptying, or generalized gastrointestinal motility dysfunction involving multiple segments of the digestive tract; 6.History of major colorectal surgery or abdominal surgery resulting in significant anatomical alterations that could affect surgical planning or postoperative outcomes; 7.Incomplete follow-up data or loss to follow-up after surgery.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Wexner Constipation Scale;Wexner Incontinence Score (WIS); | — |
Secondary
| Measure | Time frame |
|---|---|
| Gastrointestinal Quality of Life Index (GIQLI) score;Abdominal pain/bloating frequency scale;Anorectal manometry (RAIR, anal resting pressure, maximum squeeze pressure);Rectal stump length;Operative time;Time to first flatus;Postoperative complications;Hospital stay;Intraoperative blood loss; | — |
Countries
China
Contacts
Public ContactCheng Kangwen
Affiliated hangzhou first people's hospital, zhejiang university school of medicine
Outcome results
None listed