Obstructed defecation syndrome – review article
Authors:
L. Sákra; J. Šiller
Authors place of work:
Chirurgická klinika NPK, a. s.
přednosta doc. MUDr. Jiří Šiller, PhD.
Published in the journal:
Rozhl. Chir., 2017, roč. 96, č. 6, s. 247-251.
Category:
Review
Summary
Introduction:
Obstructed defecation syndrome (ODS) is one of the main causes of primary constipation. It is caused by anatomical disorders in the pelvic floor region (rectocoele, en-terocoele, rectal intussusception, rectal prolapse), but it always occurs in combination with a functional defect of defecation. This review provides a comprehensive view of the diagnosis and treatment of the syndrome.
Method:
Treatment may be conservative or surgical. Conservative treatment involves a complex of approaches to the practice of defecation, regime and dietary measures together with pelvic floor rehabilitation and psychological support. The symptoms of ODS persist in some patients despite conservative treatment and this is why these patients are eligible for surgery. Surgical approaches can be divided into transvaginal, transabdominal and transanal. Transanal procedures, associated with good short-term results and low complication rates, are used most frequently. Long-term results are still under discussion.
Conclusions:
Since ODS is caused by the combination of functional and anatomical disorders, treatment has to be targeted at a wide range of causes. Therefore, only a multidisciplinary approach as well as a combination of conservative treatment and strictly and correctly indicated surgical procedures can lead to good long-term results.
Key words:
ODS – rectocoele – intussusception – STARR
Zdroje
1. Lembo A, Camillieri M. Chronic constipation. N Engl Me 2003;349:1360–8.
2. Liu WCH, WAN SL, Yaseen SM, et al. Transanal surgery for obstructed defecation syndrome: Literature review and single-center experience. Word J Gastroenerol 2016;22:7983–98.
3. Ellis CN, Essani R. Treatment of obstructed defecation. Clin Colon Rectal Surg 2012;25:24–33.
4. Podzemny V, Pescatori LC, Pescatori M. Management of obstructed defecation. World J Gastroenterol 2015;21:1053–60.
5. M, Spyrou M, Pulvirenti d’Urso A. A prospective evaluation of occult disorders in obstructed defecation using the iceberg diagram. Colorectal Dis 2007;9:452–6.
6. Martínek J. Zácpa – aktuální přístup v diagnostice a léčbě. Med. Pro Praxi 2009; 6:6–13.
7. Madbouly KM, Abbas KS, Hussein AM. Disappointing long-term outcomes after stapled transanal rectal resection for obstructed defecation. World J Surg 2010; 34:2191–6.
8. Brown AJ, Anderson JH, McKee RF, et al.. Surgery for occult rectal prolapse. Colorectal Dis 2004;6:176–9.
9. Altomare DF, Spazzafumo L, Rinaldi M, et al. Set-up and statistical validation of a new scoring system for obstructed defaecation syndrome. Colorectal Dis 2008;10:84–8.
10. Palit S, Bhan C, Lunnis PJ, et al. Evacuation proctography: a reappraisal of normal variability. Colorecta Dis 2014;16:538–46.
11. Hwang YH, Person B, Choi JS, et al. Biofeedback therapy for rectal intussusception. Tech Coloproctol 2006;10:111–15.
12. Koch SM, Melenhorst J, van Germet WG, et al. Prospective study of colonic irrigation for the treatment of defecation disorders. Br J Surg 2008;95:1273–9.
13. Christensen P, Krogh K, Buntzen S, et al. Long-term outcome and safety of transanal irrigation for constipation and fecal incontinence. Dis Colon Rectum 2009;52:286–92.
14. Pucciani F, Reggioli M, Rinressi MN. Obstructed defeacation: what is the role of rehabilitation? Colorectal Dis 2012;14:474–9.
15. Bove A, Bellini M, Battalgia E, et al. Consensus statement AIGO/SICCR diagnosis and treatment of chronic constipation and obstructed defecation (part II: treatment). World J Gastroenterol 2012;18:4994-5013.
16. Santoro GA, Di Falco G. Benign anorectal disease. Diagnosis with endoanal and endorectal ultrasound and new treatment options. Milan, Springer 2006:376–68.
17. Faried M, El Nakeeb A, Youssef M, et al. Comparative study between surgical and non-surgical treatment of animus in patients with symptoms of obstructed defecation: A prospective randomized study. J gastrointest Surg 2010;14:1235–43.
18. Kahn MA, Stanton SL. Posterior colporrhaphy: its effect on bowel and sexual function. Br J Obstet Gynaecol 1997;104:82–6.
19. Smart NJ, Mercer-Jones MA. Functional outcome after transperineal rectocoele repair with porcine dermal collagen implant. Dis Colon rectum 2007;14:1235–43.
20. Dodi G, Pietroletti R, Milito G, et al. Bleeding, incontinence, pain and constipation after STARR transanal double stapling rectotomy for obstructed defecation. Tech Coloproctol 2003;7:148–53.
21. Naldini G. Serious unconventional complications of surgery with stapler for hemorrhoidal prolapse and obstructed defaecation because of rectocele and rectal intussusception. Colorectal Dis 2011;13: 323–7.
22. Isbert C, Reibetanz J, Jayne DG, et al. Comparative study of Contour Transtar and STARR procedure for the treatment of obstructed defecation syndrome– feasibility, morbidity and early functional results. Colorectal Dis 2010;12:901–8.
23. Mercer-Jones MA, D’Hoore A, Dixon AR, et al. Consensus on ventral rectopexy: report of a panel of experts. Colorectal Dis 2014;16:82–8.
24. Trompetto M, Clerico G, Realis Luc A, et al. Transanal Delorme procedure for treatment of rectocoele associated with rectal intussusception. Tech coloproctol 2006;10:389.
25. Boccasanta P, Venturi M, Stuto A, et al. Stapled transanal rectal resection for outlet obstruction: a prospective, multicenter trial. Dis Colon Rectum 2004;47:1285v96.
26. De Nardi P, Bottini C, Faticanti Scucchi L, et al. Proctalgia in patient with staples retained in the puborectalis muscle after STARR procedure. Tech Coloproctol 2007;11:353–6.
27. Gagiardi G, Pescatori M, Altomare DF, et al. Results, outcome predictors, and complications after stapled transanal rectal resection for obstructed defecation. Dis colon. Rectum 2008; 51:186–95.
28. Boccasanta P, Venturi M, Roviaro G. What is the benefit of a new stapler device in the surgical treatment of obstructed defecation? Three-year outcomes from a randomized controlled trial. Dis Colon rectum 201; 54:77–84.
29. Lenisa L, Shwandner O, Stuto A, et al. Starr with Contour Transtar:prospective multicentre European Study. Colorectal Dis 2009;11:821–7.
30. Ribaric G, D’Hoore A, Schiffhorts G, et al. STARR with Contour Transtar device for obstructed defecation syndrome: one-year real-world outcomes of the European Transtar registry. Int J Colorectal Dis 2014; 52:1205–12.
31. Gelos M, Frommhold K, Mann B. Severe mesorectal bleeding after stapled transanal rectal resection (STARR operation) using Contour Transtar curved cutter stapler. Colorectal Dis 2010; 12:256–66.
32. Anděl P, Škrovina M, Ducháč V. Základy praktické proktologie. Praha, Galén, 2012:185−207.
Štítky
Surgery Orthopaedics Trauma surgeryČlánok vyšiel v časopise
Perspectives in Surgery
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