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Treatment strategies for chronic constipation: our experience
Lino Succi1, Conchita Emanuela Oliveri, Antonino Carlo Privitera
1Dipartimento di Scienze Chirurgiche, Trapianti d'Organo e Tecnologie Avanzate, Università degli Studi, Catania.
Chirurgia Italiana
|October 8, 2008
Summary
Outlet dysfunction, a common cause of chronic constipation, can be treated with surgery or biofeedback. Combining therapies may improve outcomes, especially for complex cases, but careful patient selection is crucial.
Area of Science:
- Gastroenterology
- Colorectal Surgery
Background:
- Outlet dysfunction accounts for 25% of chronic constipation cases.
- Effective treatment for outlet dysfunction remains a clinical challenge.
Purpose of the Study:
- To report outcomes of surgical and biofeedback therapies for outlet dysfunction.
- To investigate the efficacy of different treatment approaches.
Main Methods:
- Retrospective analysis of 126 patients treated with surgery and/or biofeedback.
- Surgical interventions included stapled transanal rectal resection for rectal prolapse and rectocele.
- Biofeedback therapy was used as a standalone treatment or following surgery.
Main Results:
- Surgery for rectocele, rectal prolapse, and combined conditions showed success rates of 51.6%, 75%, and 78%, respectively.
- Biofeedback alone achieved an 80% improvement rate.
- Combined surgery and biofeedback resulted in a 67.8% improvement rate.
Conclusions:
- Treatment for outlet dysfunction can be complex, with varying success rates depending on the chosen therapy.
- Preoperative biofeedback may enhance surgical outcomes for obstructed defecation, particularly in patients with combined disorders.
- Stapled transanal rectal resection for rectocele may not always resolve outlet dysfunction.
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