Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Superior Rectal Artery Preservation in Laparoscopic-Assisted Subtotal Colectomy and Ileorectal Anastomosis for Slow-Transit Constipation

Version 1 : Received: 22 August 2023 / Approved: 23 August 2023 / Online: 24 August 2023 (08:07:19 CEST)

How to cite: Pu, T.-W.; Liu, Y.-H.; Kang, J.-C.; Hu, J.-M.; Chen, C.-Y. Superior Rectal Artery Preservation in Laparoscopic-Assisted Subtotal Colectomy and Ileorectal Anastomosis for Slow-Transit Constipation. Preprints 2023, 2023081702. https://doi.org/10.20944/preprints202308.1702.v1 Pu, T.-W.; Liu, Y.-H.; Kang, J.-C.; Hu, J.-M.; Chen, C.-Y. Superior Rectal Artery Preservation in Laparoscopic-Assisted Subtotal Colectomy and Ileorectal Anastomosis for Slow-Transit Constipation. Preprints 2023, 2023081702. https://doi.org/10.20944/preprints202308.1702.v1

Abstract

Our previous retrospective observational study demonstrated the safety of laparoscopically assisted subtotal colectomy with ileorectal anastomosis and preservation of the superior rectal artery (SRA), without instances of leakage, in patients with slow-transit constipation (STC). Thus, we extended the enrollment period and enlarged the sample size to detect the differences in the post-operative complications, and surgical and functional outcomes between patients who underwent laparoscopically assisted subtotal colectomy with and without SRA preservation. We conducted a retrospective single-center analysis of patients with STC who underwent laparoscopically assisted subtotal colectomy between 2016 and 2020. The diagnosis of STC was based on the colonic transit and anal functional tests, and barium enema to exclude secondary causes. Patients were divided into group A that underwent surgery with SRA preservation, and group B that underwent ligation of the SRA during surgery. Outcome assessments for both groups included the incidence of anastomotic breakdown, intraoperative complications, length of hospital stay, estimated blood loss, time to first flatus, and complications. Propensity-score matching allocated 34 patients to groups A and B each. Postoperative bowel function, including time to first flatus, stool, and oral intake, recovered better in group A than that in group B. Anastomotic leakage, a significant postoperative complication, was less frequent in patients with SRA preservation. Preservation of the SRA in patients undergoing laparoscopically assisted subtotal colectomy with ileorectal anastomosis for STC is associated with favorable postoperative bowel function recovery and lower anastomotic leakage rates.

Keywords

slow-transit constipation; superior rectal artery; anastomosis leakage

Subject

Biology and Life Sciences, Anatomy and Physiology

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