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Surgical Interventions for Functional Constipation: An Update.

Alejandra Vilanova-Sanchez1, Marc A Levitt2

  • 1Deparment of Pediatric Surgery, Urogenital and Colorectal Unit, La Paz University Hospital Children Hospital, Madrid, Comunidad de Madrid, Spain.

European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery ... [Et Al] = Zeitschrift Fur Kinderchirurgie
|September 28, 2020
PubMed
Summary
This summary is machine-generated.

Chronic idiopathic constipation in children often requires surgical evaluation when laxatives fail. This review details surgical options and guides selection for improved colorectal motility and reduced fecal retention.

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Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Colorectal Surgery

Background:

  • Chronic idiopathic constipation (functional constipation) is difficult, infrequent defecation without a clear organic cause.
  • While laxatives help most children, some require surgical assessment due to complications like fecal retention and rectal distension.
  • Progressive constipation can impair normal colorectal motility, necessitating advanced interventions.

Purpose of the Study:

  • To review surgical interventions for pediatric functional constipation.
  • To provide guidance on selecting the optimal surgical procedure based on patient-specific evaluations.

Main Methods:

  • Review of current surgical options for refractory functional constipation.
  • Discussion of diagnostic tools influencing surgical decision-making: rectal biopsy, transit studies, contrast enema, manometry, and motility evaluation.

Main Results:

  • Surgical interventions include intestinal diversion, antegrade enemas, sacral nerve stimulation, colonic resections, and Botulinum toxin injection.
  • Patient evaluation data (biopsy, transit, imaging, manometry, motility) are crucial for procedure selection.

Conclusions:

  • A subset of children with functional constipation benefits from surgical management.
  • Tailoring surgical interventions based on comprehensive diagnostic evaluations is key to successful outcomes.