Subtotal colectomy matches total for constipation

For severe slow-transit constipation, removing less colon gave similar symptom relief at one year, with less early incontinence.

• Among 252 patients, subtotal colectomy was noninferior to total colectomy for constipation symptoms at one year.
• Incontinence at three months affected 8.7% after subtotal versus 21.4% after total colectomy.
• Subtotal surgery left the cecum and connected it to the rectum; total surgery connected the small bowel to the rectum.

Satisfaction slightly favored total colectomy, while complications and quality of life were similar. Longer follow-up is needed.