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Electroacupuncture Combined with Chinese Medicine Ironing Therapy for Functional Constipation
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Surgery for constipation: systematic review and clinical guidance: Paper 1: Introduction & Methods.

C H Knowles1, U Grossi1, E J Horrocks1

  • 1National Bowel Research Centre, Blizard Institute, Queen Mary University London, London, UK.

Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland
|September 30, 2017
PubMed
Summary
This summary is machine-generated.

Surgical interventions for chronic constipation in adults have a poor evidence base. Expert consensus exists on best practices, but further research is needed to guide future treatments and funding.

Keywords:
Constipationobstructed defaecationsurgery

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Area of Science:

  • Gastroenterology
  • Surgical Innovation
  • Evidence-Based Medicine

Background:

  • Chronic constipation affects a significant adult population.
  • Surgical interventions are employed, but their efficacy and safety require rigorous assessment.
  • Developing evidence-based guidelines for surgical management is crucial.

Purpose of the Study:

  • To introduce the methodology for systematic reviews on surgical treatments for chronic constipation.
  • To assess the outcomes of surgical interventions for adult chronic constipation.
  • To develop evidence-based recommendations for clinical practice.

Main Methods:

  • Adherence to PRISMA guidelines for systematic reviews.
  • Comprehensive literature search from 1960 to 2016.
  • Inclusion of studies meeting strict PICOS criteria.
  • Systematic reviews conducted by a UK clinical guidance group.
  • Evaluation of recommendations by a European Consensus group using RAND/UCLA methodology.

Main Results:

  • 156 studies were included, covering colonic resection, rectal suspension, rectal wall excision, rectovaginal septum reinforcement, and sacral nerve stimulation.
  • The overall quality of evidence was poor (72.4% were Oxford Level IV).
  • 99 summary evidence statements (SES) and 100 prototype graded practice recommendations (GPRs) were generated.
  • 85 GPRs were deemed appropriate by European Consensus.

Conclusions:

  • The current evidence base for surgical management of chronic constipation is inadequate.
  • Expert consensus provides some guidance on best practices.
  • Further high-quality studies are essential for informed treatment decisions and research funding allocation.