Mortality, morbidity and functional outcome after total or subtotal abdominal colectomy in the asian population

Objective:  This study reviews the functional outcome and satisfaction of patients after subtotal or total colectomy (STTC). Methods:  A retrospective review of patients who underwent STTC between June 1999 and September 2003 was performed. A standardized questionnaire was formulated and phone interviews were conducted with these patients. Results:  There were 50 patients who underwent STTC during this period. The most common indications were bleeding diverticular disease, patients with synchronous colorectal cancers or polyps and left-sided colonic obstruction. The presence of ischaemic heart disease and the development of perioperative acute coronary syndrome were found to be statistically significant predictors of 30 day mortality with P = 0.01 and 0.05, respectively. Phone interviews were successfully conducted in 33 patients. The patients interviewed were between 4 and 54 months postsurgery. Ninety-four percent reported that they were either happy or satisfied. Cleveland Clinic Incontinence Score (CCIS) revealed good or perfect continence in 94% of patients. Less than one-quarter of those interviewed had five or more bowel movements in a day while most had either two or three bowel movements a day. Patient satisfaction after STTC correlated strongly with the severity of CCIS and number of bowel movements a day (P < 0.01). Also, those with less than five bowel movements a day were more likely to report a better satisfaction (P < 0.01). Conclusion:  Subtotal or total colectomy is associated with a good functional outcome and most patients were satisfied with their bowel function on follow-up.