Transanal proximal rectosigmoidectomy: a single-center experience in surgically treated severe medically refractory idiopathic constipation
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In brief
In brief
This single-center study of 14 pediatric patients demonstrates that transanal proximal rectosigmoidectomy effectively treats severe medically refractory idiopathic constipation, eliminating daily fecal accidents in all patients and reducing healthcare utilization and medication requirements. Half the cohort had moderate-to-severe autism, highlighting applicability in complex populations.
- Transanal proximal rectosigmoidectomy (TPRS) eliminated daily fecal accidents in all 14 patients with severe refractory constipation
- Post-operative outcomes showed reduced laxative requirements, fewer ER visits, and decreased need for procedural interventions
- Half of the cohort had moderate-to-severe autism, suggesting TPRS may benefit neurodevelopmentally complex patients
- Surgical intervention improved quality of life when medical management failed in pediatric idiopathic constipation
- TPRS reduced healthcare utilization including clinic visits, family calls, and hospitalizations for constipation complications
Written by the GCMD Library team from the article.
Abstract
Purpose
To present the functional results after a transanal proximal rectosigmoidectomy in patients with severe idiopathic constipation in which medical treatment has failed.
Methods
Patients with severe idiopathic constipation who underwent transanal proximal rectosigmoidectomy (TPRS) at Children’s Hospital Colorado between June 2019 and March 2024 were included in the study. We compared multiple pre- and post-operative outcome measures and the patient’s bowel regimen before and after resection.
Results
Fourteen patients underwent TPRS, 10 of whom were male. The average age at the time of surgery was 10.1 years (range 5–19). Seven patients have moderate to severe autism. Constipation-related clinic visits, family calls, procedural intervention, emergency room visits, and hospitalizations notably decreased frequency after TPRS. Laxative dosages and enema volume requirements were also reduced after surgery. Before surgery, all the patients suffered from daily fecal accidents, while post-operatively, all were completely free of stool accidents.
Conclusion
In our experience, for patients who suffer from severe medically refractory idiopathic constipation, TPRS has provided improvement in their symptoms and decreased the complications inherent to this chronic disease. Parents and patients attest to a profound positive transformation in their quality of life after surgery.