关于对抗性便秘的评估和管理的AGA临床实践更新:专家评价
Kyle Staller1, Leila Neshatian2, Anthony Lembo3
1Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
概括
耐火性便秘 (RC) 需要排除次要原因并确认慢慢的结肠过渡. 手术是严重RC的选择,但由于潜在的风险和结果,需要仔细评估,包括心理评估.
科学领域:
- 胃肠病学 胃肠病学
- 结肠直肠手术 结肠直肠手术
背景情况:
- 一部分患者经历了耐药性便秘 (RC),尽管医疗治疗,呈现诊断和治疗方面的挑战.
- 由于RC相对罕见,因此需要对诊断和管理采取系统的方法.
研究的目的:
- 为诊断和治疗耐火性便秘提供专家指导.
- 在考虑为慢性便秘进行手术干预之前,概述评估患者的最佳实践.
主要方法:
- 专家审查由美国胃肠病学协会 (AGA) 委托并批准.
- 根据对已发表文献和专家意见的审查得出的陈述.
- 内部和外部的同行评审过程.
主要成果:
- 系统地排除可纠正的次要原因 (药物,神经疾病,排便障碍) 是至关重要的.
- 在考虑手术之前,确认慢慢的结肠过渡和医疗/非药物治疗的充分试验是必不可少的.
- 手术治疗 (例如,切除肠道) 需要仔细选择患者,排除并发的DDS,评估上肠动性,并考虑心理并发症.
结论:
- 对于RC的手术治疗具有风险和潜在的不令人满意的结果,要求进行彻底的手术前评估.
- 建议进行心理评估,以评估人是否适合进行手术,并预测结果.
- 带有大肠直肠解剖的结肠切除术应保留给没有正在进行的排便障碍的患者.
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