Background: In 2014, we reported single-incision clipless laparoscopic total colectomy (SCLTC) with ileorectal anastomosis (IRA) as a type of reduced-port surgery for several benign diseases. Patients with intractable slow transit constipation (STC) have undergone SCLTC with IRA since it was introduced in our institution. However, the feasibility and usefulness of the surgical procedure for patients with intractable STC has not been elucidated.
Methods: From January 2011 to December 2018, twenty-two patients with intractable STC underwent SCLTC with IRA at Kashiwa Hospital, Jikei University, were retrospectively registered in this study. We compared the first 12 consecutive patients undergoing the double stapling technique (DST) with IRA (DST group) with the last 10 consecutive patients undergoing functional end-to-end anastomosis (FEEA) with IRA (FEEA group).
Results: The mean surgical time was 200.2 (150-249) min for the FEEA group and 230.7 (180-266) min for the DST group. A significant difference was identified between the two groups (0.035). There were no significant differences between the groups with respect to the mean age, sex, constipation type, intraoperative blood loss, or postoperative hospital stay. No postoperative complications were encountered in either group.
Conclusion: Although SCLTC cannot be easily introduced for intractable STC, SCLTC with IRA using FEEA is feasible and safe.