Contribution of Percutaneous Endoscopic Caecostomie in the Management of Severe Constipation Refractory to Medical Treatment

Launched by NANTES UNIVERSITY HOSPITAL · Oct 1, 2015

Keywords

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Gender

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Eligibility criteria

• Inclusion Criteria:
• • Patient betwen 18 and 75 years old
• • Chronic constipation defined by the Rome III classification
• • Transit time with pellets made within 24 months preceding the inclusion visit indicating a transit time of at least 120 hours and/or with a Neurogenic bowel dysfunction ≥ 14 for patients with spina bifida and / or spinal cord injuries.
• • Colonoscopy made within the 5 years preceding the inclusion visit indicating the absence of colorectal organic obstacle
• • Anorectal manometry performed within 24 months preceding the inclusion visit performed to substantiate the information on the type of constipation
• • GIQLI score \<121 and Kess Questionnaire score\> 7, despite medical treatment of constipation including taking a laxative (stimulant laxative orally and / or suppository and / or retrograde enema) more than one times per week for at least two months.
• • Affiliation to a social security
• • - Chronic constipation defined by the Rome III classification
• • Transit time with pellets made within 24 months preceding the inclusion visit indicating an increase of at least 120 hours compared to normal
• • Colonoscopy made within the 24 months preceding the inclusion visit indicating the absence of colorectal organic obstacle
• • Anorectal manometry performed in the 24 months preceding the inclusion visit performed to substantiate the information on the type of constipation
• • Score GIQLI love \<121 and Kess Questionnaire score\> 7, despite medical treatment of constipation including taking a laxative (stimulant laxative orally and / or suppository and / or retrograde enema) more than one times per week for at least two months.
• • Affiliation to a social security scheme
• • Informed consent signed
• Exclusion Criteria:
• • Severe obesity (BMI\> 40)
• • History of surgical resection of colon
• • Hypothyroidism, electrolyte disorders, insulin-dependent diabetes
• • Acute decompensation of depressive syndrome
• • Immunosuppressive therapy
• • Disorders of hemostasis (TP \<70%, APTT\> 1.5, thrombocytopenia \<70,000 / mm3)
• • Pregnant woman (positive serum beta-hCG) or breastfeeding
• • Adults under guardianship, curatorship or under court protection
• • Participation in another research protocol on the treatment of constipation