Liu WC, Wan SL, Yaseen S, Ren XH, Tian CP, Ding Z, Zheng KY, Wu YH, Jiang CQ, Qian Q. Transanal surgery for obstructed defecation syndrome: Literature review and a single-center experience. World J Gastroenterol 2016; 22(35): 7983-7998 [PMID: 27672293 DOI: 10.3748/wjg.v22.i35.7983]
Corresponding Author of This Article
Qun Qian, MD, PhD, Professor, Chief, Department of Colorectal and Anal Surgery of Zhongnan Hospital of Wuhan University, Key Laboratory of Intestinal and Colorectal Diseases of Hubei Province, Quality Control Center of Colorectal and Anal Surgery of Health and Family Planning Commission of Hubei Province, Clinical Center of Intestinal and Colorectal Diseases of Hubei Province, Wuhan 430071, Hubei Province, China. qunqian2007@163.com
Research Domain of This Article
Surgery
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Wei-Cheng Liu, Song-Lin Wan, SM Yaseen, Xiang-Hai Ren, Cui-Ping Tian, Zhao Ding, Ken-Yan Zheng, Yun-Hua Wu, Cong-Qing Jiang, Qun Qian, Department of Colorectal and Anal Surgery of Zhongnan Hospital of Wuhan University, Key Laboratory of Intestinal and Colorectal Diseases of Hubei Province, Quality Control Center of Colorectal and Anal Surgery of Health and Family Planning Commission of Hubei Province, Clinical Center of Intestinal and Colorectal Diseases of Hubei Province, Wuhan 430071, Hubei Province, China
Author contributions: Liu WC substantially contributed to the design of the study, the literature review, and the drafting of the initial manuscript; Wan SL contributed to the literature review and the drafting of the manuscript; Yaseen SM contributed to the article drafting; Ren XH contributed to the analysis and interpretation of data; Tian CP contributed to the drafting of the manuscript; Ding Z, Zheng KY and Wu YH contributed to the acquisition of data; Jiang CQ and Qian Q contributed to the conception and design of the study; all authors made critical revisions related to important intellectual content of the manuscript and gave final approval of the version of the article to be published.
Supported byNational Natural Science Foundation of China, No. 81500505 and No. 81570492; and Natural Science Foundation of Hubei Province of China, No. 2015CFB636.
Conflict-of-interest statement: The authors declare no conflict of interests in this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Qun Qian, MD, PhD, Professor, Chief, Department of Colorectal and Anal Surgery of Zhongnan Hospital of Wuhan University, Key Laboratory of Intestinal and Colorectal Diseases of Hubei Province, Quality Control Center of Colorectal and Anal Surgery of Health and Family Planning Commission of Hubei Province, Clinical Center of Intestinal and Colorectal Diseases of Hubei Province, Wuhan 430071, Hubei Province, China. qunqian2007@163.com
Telephone: +86-27-67812778 Fax: +86-27-67812778
Received: March 24, 2016 Peer-review started: March 25, 2016 First decision: May 12, 2016 Revised: June 23, 2016 Accepted: August 1, 2016 Article in press: August 1, 2016 Published online: September 21, 2016 Processing time: 174 Days and 1.1 Hours
Abstract
Obstructed defecation syndrome (ODS) is a functional disorder commonly encountered by colorectal surgeons and gastroenterologists, and greatly affects the quality of life of patients from both societal and psychological aspects. The underlying anatomical and pathophysiological changes of ODS are complex. However, intra-rectal intussusception and rectocele are frequently found in patients with ODS and both are thought to play an important role in the pathogenesis of ODS. With the development of evaluation methods in anorectal physiology laboratories and radiology studies, a great variety of new operative procedures, especially transanal procedures, have been invented to treat ODS. However, no procedure has been proved to be superior to others at present. Each operation has its own merits and defects. Thus, choosing appropriate transanal surgical procedures for the treatment of ODS remains a challenge for all surgeons. This review provides an introduction of the current problems and options for treatment of ODS and a detailed summary of the essential assessments needed for patient evaluation before carrying out transanal surgery. Besides, an overview of the benefits and problems of current transanal surgical procedures for treatment of ODS is summarized in this review. A report of clinical experience of some transanal surgical techniques used in the authors’ center is also presented.
Core tip: Transanal surgery for obstructed defecation syndrome (ODS) remains a challenge for colorectal surgeons. Possible reasons are that reported clinical outcomes of current transanal surgical procedures are controversial and the patient selection criteria for different procedures are usually deficiently described in the current literature. This article reviews the literature regarding transanal surgery, introduces current problems and options for treatment of ODS and summarizes essential assessments needed for patient evaluation and the benefits and problems of each procedure. The aim of this article is to improve the understanding of selective strategies of transanal operations and increase patient satisfaction.
