Background: Slow-transit constipation complicated with rectocele is a mixed constipation difficult to treat by surgery. Different hospitals and surgeons may employ different surgical procedures. The present study aims to compare the efficacy of laparoscopic subtotal colectomy (LSC) with posterior vaginal suspension and LSC with transvaginal repair for patients having refractory slow-transit constipation complicated with rectocele.
Methods: This paper is a retrospective study of 64 patients having refractory slow-transit constipation complicated with rectocele. Admitted from January 2002 to December 2012, the 64 patients were non-randomly divided into two groups: patients who underwent LSC with posterior vaginal suspension (Group A, 36 patients) and patients who underwent LSC with transvaginal repair (Group B, 28 patients).
Results: There was no statistically significant difference (P > 0.05) in preoperative general characteristics and Wexner constipation score between Group A and Group B. There was no statistically significant difference (P > 0.05) in operative time and intraoperative blood loss between the two groups. One month after the surgery, there was no statistically significant difference (P > 0.05) in early postoperative complications, constipation recurrence rate, degree of improvement in constipation symptoms, and Wexner constipation score between the two groups. But 1-year follow-up results show that there was statistically significant difference (P < 0.05) in constipation recurrence rate, gastrointestinal quality of life index, the degree of improvement in constipation symptoms, and Wexner constipation score between the two groups.
Conclusion: Compared with the LSC with transvaginal repair, the LSC with posterior vaginal suspension demonstrated better efficacy in treating refractory slow-transit constipation complicated with rectocele.
Keywords: Laparoscopic subtotal colectomy; Posterior vaginal suspension; Rectocele; Slow-transit constipation; Transvaginal repair.