“Imola-Montecatone” Subtotal Colectomy to Improve Bowel Management in Spinal Cord Injury Patients. Retrospective Analysis in 19 Cases

Study design Retrospective single-center study. Objectives Persons with spinal cord injury live with neurogenic bowel dysfunction. Difficulties with management of neurogenic bowel can increase over time with age and time post injury, with a negative impact on autonomy and quality of life. Many conservative treatments are available to improve bowel management; however, in case of failure, a colostomy may be considered. Setting Specialized Care Unit, Montecatone Rehabilitation Institute and General Surgery Division, Imola Hospital, Imola, Italy. Methods From 2016 to 2019, selected patients affected by SCI and bowel dysfunction failing conservative care were treated with subtotal colectomy associated with placement of a bioabsorbable prosthesis, to prevent parastomal hernia. The surgical procedure is presented along with results. Results Overall, 19 individuals underwent the described procedure; after 1 year of follow-up, we observed four minor complications: two cases of dehiscence of the abdominal incision, easily treated during hospital stay, and two cases of leakage of mucorrhoea. Conclusion Our results demonstrate the efficacy of the procedure to improve bowel management in persons with spinal cord injury.