1
|
Seo M, Bae JH. Nonpharmacologic Treatment of Chronic Constipation. THE KOREAN JOURNAL OF GASTROENTEROLOGY = TAEHAN SOHWAGI HAKHOE CHI 2024; 83:191-196. [PMID: 38783620 DOI: 10.4166/kjg.2024.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 05/06/2024] [Accepted: 05/06/2024] [Indexed: 05/25/2024]
Abstract
Functional constipation is a common clinical diagnosis that affects approximately 14% of the world's population. Non-pharmacological therapies often represent the initial steps in management and may include lifestyle adjustments or changes such as physical activity and diet. Pharmacological options have been used when the non-pharmacological approach has been ineffective. Biofeedback therapy, surgery, sacral nerve stimulation, botulinum toxin injection, and vibrating capsules can be considered in scenarios where the laxatives are ineffective. Biofeedback therapy is highly effective and safe in treating dyssynergic defecation, which affects more than half of patients with chronic constipation. This paper overviews non-pharmacological therapies for functional constipation.
Collapse
Affiliation(s)
- Myeongsook Seo
- Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea
| | - June Hwa Bae
- Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu, Korea
| |
Collapse
|
2
|
Pu TW, Liu YH, Kang JC, Hu JM, Chen CY. Superior Rectal Artery Preservation in Laparoscopically Assisted Subtotal Colectomy and Ileorectal Anastomosis for Slow-Transit Constipation. Biomedicines 2024; 12:965. [PMID: 38790927 PMCID: PMC11118226 DOI: 10.3390/biomedicines12050965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 04/16/2024] [Accepted: 04/22/2024] [Indexed: 05/26/2024] Open
Abstract
Our previous retrospective observational study demonstrated the safety of laparoscopically assisted subtotal colectomy with ileorectal anastomosis and preservation of the superior rectal artery (SRA), without instances of leakage, in patients with slow-transit constipation (STC). Thus, we extended the enrollment period and enlarged the sample size to detect the differences in the postoperative complications and surgical and functional outcomes between patients who underwent laparoscopically assisted subtotal colectomy with and without SRA preservation. We conducted a retrospective single-center analysis of patients with STC who underwent laparoscopically assisted subtotal colectomy between 2016 and 2020. The diagnosis of STC was based on the colonic transit and anal functional tests and barium enema to exclude secondary causes. Patients were divided into group A, which underwent surgery with SRA preservation, and group B, which underwent ligation of the SRA during surgery. Outcome assessments for both groups included the incidence of anastomotic breakdown, intraoperative complications, length of hospital stay, estimated blood loss, time to first flatus, and complications. Propensity score matching allocated 34 patients to groups A and B each. Postoperative bowel function, including time to first flatus, stool, and oral intake, recovered better in group A than in group B. Anastomotic leakage, a significant postoperative complication, was less frequent in patients with SRA preservation. In conclusion, preservation of the SRA in patients undergoing laparoscopically assisted subtotal colectomy with ileorectal anastomosis for STC is associated with favorable postoperative bowel function recovery and lower anastomotic leakage rates.
Collapse
Affiliation(s)
- Ta-Wei Pu
- Division of Colon and Rectal Surgery, Department of Surgery, Songshan Branch, Tri-Service General Hospital, National Defense Medical Center, Taipei 10581, Taiwan;
| | - Yu-Hong Liu
- Division of Colorectal Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan; (Y.-H.L.); (J.-M.H.)
| | - Jung-Cheng Kang
- Division of Colon and Rectal Surgery, Department of Surgery, Taiwan Adventist Hospital, Taipei 10556, Taiwan;
| | - Je-Ming Hu
- Division of Colorectal Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan; (Y.-H.L.); (J.-M.H.)
| | - Chao-Yang Chen
- Division of Colorectal Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan; (Y.-H.L.); (J.-M.H.)
| |
Collapse
|
3
|
Xue X, Zeng H, Chen D, Zheng B, Liang B, Xu D, Lin S. Comparing the short-term clinical outcomes and therapeutic effects of different colectomies in patients with refractory slow-transit constipation in eastern countries: a network meta-analysis. Updates Surg 2024; 76:411-422. [PMID: 38329678 DOI: 10.1007/s13304-024-01762-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 01/16/2024] [Indexed: 02/09/2024]
Abstract
Surgical treatment has been widely used in patients with refractory slow transit constipation (RSTC). The aim of this network meta-analysis (NMA) was to compare the effects of different colectomies on short-term postoperative complications and quality of life in patients with RSTC. Electronic literature searches were performed in the PubMed, Web of Science, EMBASE, WANFANG DATA, and Cochrane Central Register of controlled trials databases and were searched up to December 2022. Selected to compare the short-term clinical outcomes and quality of life of the treatment of RSTC. A random-effects Bayesian NMA was conducted to assess and rank the effectiveness of different surgical modalities. This study included a total of six non-randomized controlled trials involving 336 subjects. It was found that subtotal colectomy with cecorectal anastomosis (CRA) demonstrated superior effectiveness in several aspects, including reduced hospital stay (MD 0.06; 95% CI [0.02, 1.96]), shorter operative time (MD 4.75; 95% CI [0.28, 14.07]), lower constipation index (MD 0.61; 95% CI [0.04, 1.71]), improved quality of life (MD 4.42; 95% CI [0.48, 4.42]). Additionally, in terms of short-term clinical outcomes, subtotal colectomy with ileosigmoidal anastomosis (SC-ISA) procedure ranked the highest in reducing small bowel obstruction (OR 0.24; 95% CI [0.02, 0.49]), alleviating abdominal pain (OR 0.53; 95% CI [0.05, 1.14]), minimizing abdominal distension (OR 0.33; 95% CI [0.02, 0.65]), and reducing incision infection rates (OR 0.17; 95% CI [0.01, 0.33]). Furthermore, SC-ISA ranked as the best approach in terms of patient satisfaction (OR 0.66; 95% CI [0.02, 1.46]). Based on our research findings, we recommend that CRA be considered as the preferred treatment approach for patients diagnosed with RSTC.
Collapse
Affiliation(s)
- Xueyi Xue
- Department of Gastroenterology and Anorectal Surgery, Longyan First Affiliated Hospital of Fujian Medical University, No. 105 Jiuyi North Road, Longyan, 364000, Fujian, China
| | - Hao Zeng
- Department of Gastroenterology and Anorectal Surgery, Longyan First Affiliated Hospital of Fujian Medical University, No. 105 Jiuyi North Road, Longyan, 364000, Fujian, China
- Fujian Medical University, Fuzhou, China
| | - Dongbo Chen
- Department of Gastroenterology and Anorectal Surgery, Longyan First Affiliated Hospital of Fujian Medical University, No. 105 Jiuyi North Road, Longyan, 364000, Fujian, China
| | - Biaohui Zheng
- Department of Gastroenterology and Anorectal Surgery, Longyan First Affiliated Hospital of Fujian Medical University, No. 105 Jiuyi North Road, Longyan, 364000, Fujian, China
| | - Baofeng Liang
- Department of Gastroenterology and Anorectal Surgery, Longyan First Affiliated Hospital of Fujian Medical University, No. 105 Jiuyi North Road, Longyan, 364000, Fujian, China
- Department of Outpatient Services, Shanghang County Hospital, Longyan, Fujian, China
| | - Dongbo Xu
- Department of Gastroenterology and Anorectal Surgery, Longyan First Affiliated Hospital of Fujian Medical University, No. 105 Jiuyi North Road, Longyan, 364000, Fujian, China
| | - Shuangming Lin
- Department of Gastroenterology and Anorectal Surgery, Longyan First Affiliated Hospital of Fujian Medical University, No. 105 Jiuyi North Road, Longyan, 364000, Fujian, China.
| |
Collapse
|
4
|
Swanson KA, Phelps HM, Chapman WC, Glasgow SC, Smith RK, Joerger S, Utterson EC, Shakhsheer BA. Surgery for chronic idiopathic constipation: pediatric and adult patients - a systematic review. J Gastrointest Surg 2024; 28:170-178. [PMID: 38445940 DOI: 10.1016/j.gassur.2023.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 11/25/2023] [Accepted: 12/08/2023] [Indexed: 03/07/2024]
Abstract
BACKGROUND Chronic idiopathic constipation (CIC) is a substantial problem in pediatric and adult patients with similar symptoms and workup; however, surgical management of these populations differs. We systematically reviewed the trends and outcomes in the surgical management of CIC in pediatric and adult populations. METHODS A literature search was performed using Ovid MEDLINE, Embase, Scopus, the Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov between January 1, 1995 and June 26, 2020. Clinical trials and retrospective and prospective studies of patients of any age with a diagnosis of CIC with data of at least 1 outcome of interest were selected. The interventions included surgical resection for constipation or antegrade continence enema (ACE) procedures. The outcome measures included bowel movement frequency, abdominal pain, laxative use, satisfaction, complications, and reinterventions. RESULTS Adult patients were most likely to undergo resection (94%), whereas pediatric patients were more likely to undergo ACE procedures (96%) as their primary surgery. Both ACE procedures and resections were noted to improve symptoms of CIC; however, ACE procedures were associated with higher complication and reintervention rates. CONCLUSION Surgical management of CIC in pediatric and adult patients differs with pediatric patients receiving ACE procedures and adults undergoing resections. The evaluation of resections and long-term ACE data in pediatric patients should be performed to inform patients and physicians whether an ACE is an appropriate procedure despite high complication and reintervention rates or whether resections should be considered as an initial approach for CIC.
Collapse
Affiliation(s)
- Kerry A Swanson
- Department of Surgery, Washington University in St. Louis, St. Louis, Missouri, United States.
| | - Hannah M Phelps
- Department of Surgery, Washington University in St. Louis, St. Louis, Missouri, United States
| | - William C Chapman
- Department of Surgery, Washington University in St. Louis, St. Louis, Missouri, United States
| | - Sean C Glasgow
- James H. Quillen Veterans Affairs Medical Center, Mountain Home, Tennessee, United States; Eastern Tennessee State University, Johnson City, Tennessee, United States
| | - Radhika K Smith
- Advent Health Medical Center, Orlando, Florida, United States
| | - Shannon Joerger
- Division of Pediatric Gastroenterology, Department of Pediatrics, Washington University in St. Louis, St. Louis, Missouri, United States
| | - Elizabeth C Utterson
- Division of Pediatric Gastroenterology, Department of Pediatrics, Washington University in St. Louis, St. Louis, Missouri, United States
| | - Baddr A Shakhsheer
- Section of Pediatric Surgery, Department of Surgery, Comer Children's Hospital, The University of Chicago, Chicago, Illinois, United States
| |
Collapse
|
5
|
Sun K, Xie X, Hu J, Qian Q, Liu W, Hong Y, Chen B, Xie H, Yan H, Ren X, Jiang C. Degree of transverse colon ptosis: an alternative surrogate for evaluation of slow transit constipation. Quant Imaging Med Surg 2023; 13:5664-5675. [PMID: 37711817 PMCID: PMC10498202 DOI: 10.21037/qims-23-28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 07/11/2023] [Indexed: 09/16/2023]
Abstract
Background Although transverse colon ptosis (TCP) is commonly diagnosed in patients with constipation, it has not attracted significant attention in the evaluation of constipation. Herein, we assessed the correlation between TCP-related radiological parameters and the severity of slow transit constipation (STC). Methods This study was a single-center retrospective cohort study, with participants enrolled between 2012 and 2020 in Zhongnan Hospital of Wuhan University, China. STC was diagnosed according to Rome IV criteria and results of colonic transit test (CTT); healthy volunteers were also recruited as controls. All participants were examined using abdominal X-rays (AXRs) to acquire the radiological parameters related to TCP. Among these parameters, the degree of TCP (DTCP) was defined as the vertical distance from the top of the splenic flexure to the lowest point of the reverse colon. The Wexner Constipation Score and Hospital Anxiety and Depression Scale were used to assess clinical severity. After multivariable linear regression, the correlations between radiological parameters and severity of STC were investigated. We also explored the differences in radiological parameters between the operation and the conservative group. Results The study included 139 patients with STC and 125 healthy people in as the normal control (NC). Patients with STC probably had larger DTCPs than those in the NC group (242.27±25.86 vs. 93.00±32.57 mm; P<0.001). Pearson correlation analysis showed that TCP-related parameters were consistent with the symptom severity of STC [e.g., parameter DTCP was strongly correlated with Wexner Constipation Score, with a β coefficient (95% CI) of 8.63 (8.24-9.02), P<0.001]. Multivariable linear regression models showed that patients with a larger DTCP were more likely to undergo surgery (23.67; 95% CI: 1.40-45.94; P=0.04). Conclusions TCP-related parameters, especially the DTCP, may serve as novel and feasible alternative indices for the assessment of STC. However, the potential value of DTCP in assisting the evaluation of STC needs to be confirmed in study with a larger sample size.
Collapse
Affiliation(s)
- Kongliang Sun
- Department of Colorectal and Anal Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
- Department of Ophthalmology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Xiaoyu Xie
- Department of Colorectal and Anal Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Jinxiang Hu
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Qun Qian
- Department of Colorectal and Anal Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
- Clinical Center of Intestinal and Colorectal Diseases of Hubei Province, Wuhan, China
- Key Laboratory of Intestinal and Colorectal Diseases of Hubei Province, Wuhan, China
- Colorectal and Anal Disease Research Center, Medical School of Wuhan University, Wuhan, China
- Quality Control Center of Colorectal and Anal Surgery, Health Commission of Hubei Province, Wuhan, China
| | - Weicheng Liu
- Department of Colorectal and Anal Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
- Clinical Center of Intestinal and Colorectal Diseases of Hubei Province, Wuhan, China
- Key Laboratory of Intestinal and Colorectal Diseases of Hubei Province, Wuhan, China
- Colorectal and Anal Disease Research Center, Medical School of Wuhan University, Wuhan, China
| | - Yuntian Hong
- Department of Colorectal and Anal Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
- Clinical Center of Intestinal and Colorectal Diseases of Hubei Province, Wuhan, China
- Key Laboratory of Intestinal and Colorectal Diseases of Hubei Province, Wuhan, China
| | - Baoxiang Chen
- Department of Colorectal and Anal Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
- Clinical Center of Intestinal and Colorectal Diseases of Hubei Province, Wuhan, China
- Key Laboratory of Intestinal and Colorectal Diseases of Hubei Province, Wuhan, China
| | - Huixuan Xie
- Department of Colorectal and Anal Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Hong Yan
- School of Health Sciences, Wuhan University, Wuhan, China
| | - Xianghai Ren
- Department of Colorectal and Anal Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
- Clinical Center of Intestinal and Colorectal Diseases of Hubei Province, Wuhan, China
- Key Laboratory of Intestinal and Colorectal Diseases of Hubei Province, Wuhan, China
- Colorectal and Anal Disease Research Center, Medical School of Wuhan University, Wuhan, China
- Quality Control Center of Colorectal and Anal Surgery, Health Commission of Hubei Province, Wuhan, China
| | - Congqing Jiang
- Department of Colorectal and Anal Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
- Clinical Center of Intestinal and Colorectal Diseases of Hubei Province, Wuhan, China
- Key Laboratory of Intestinal and Colorectal Diseases of Hubei Province, Wuhan, China
- Colorectal and Anal Disease Research Center, Medical School of Wuhan University, Wuhan, China
- Quality Control Center of Colorectal and Anal Surgery, Health Commission of Hubei Province, Wuhan, China
| |
Collapse
|
6
|
Deng XM, Zhu TY, Wang GJ, Gao BL, Li RX, Wang JT. Laparoscopic total colectomy with ileorectal anastomosis and subtotal colectomy with antiperistaltic cecorectal anastomosis for slow transit constipation. Updates Surg 2023:10.1007/s13304-023-01458-y. [PMID: 36914915 DOI: 10.1007/s13304-023-01458-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 02/09/2023] [Indexed: 03/14/2023]
Abstract
To investigate the clinical efficacy of laparoscopic total colectomy with ileorectal anastomosis (TC-IRA) and laparoscopic subtotal colectomy with antiperistaltic cecorectal anastomosis (SC-ACRA) on adults with slow transit constipation (STC). One hundred and three patients with STC were assigned to the TC-IRA group (n = 53) and the SC-ACRA group (n = 50). The clinical data were analyzed. The surgery was successful in all patients (100%). Significantly (P = 0.03) more patients took anti-laxatives during hospitalization in the TC-IRA than the SC-ACRA group (39.62% vs. 20.00%). Abdominal pain and distension was present in 33.96% and 32.00% patients in the TC-IRA and SC-ACRA group, respectively, which decreased insignificantly (P > 0.05) to 18.87% and 18.00% 24 months after surgery, respectively. The postoperative Wexner and gastrointestinal quality of life (GIQLI) scores were not significantly different (P > 0.05) at all times after surgery in both groups. The defecation frequency decreased in both groups, and the average defecation frequency was significantly (P < 0.05) higher in the TC-IRA than the SC-ACRA group (3.91 ± 1.23 vs. 3.14 ± 1.15 times/day) at 3 months. Three months after surgery, significantly (P < 0.05) fewer patients were satisfied with defecation frequency in the TC-IRA than the SC-ACRA group (29 vs. 37 patients), whereas the number of patients who were willing to choose the same procedure again was not significantly (P > 0.05) different between the two groups. The WIS score of patients was significantly (P = 0.035) higher in the TC-IRA than the SC-ACRA group (6 vs. 5) 3 months later. TC-IRA and SC-ACRA are both safe and effective for adult slow transit constipation, and can significantly improve the quality of life of patients. Even though SC-ACRA has better early defecation frequency, postoperative antidiarrheal application and satisfaction, the long-term follow-up effects are similar.
Collapse
Affiliation(s)
- Xiu-Mei Deng
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Zhengzhou University, 1 Jianshe Road, Zhengzhou, 450052, China
| | - Tian-Yu Zhu
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Zhengzhou University, 1 Jianshe Road, Zhengzhou, 450052, China
| | - Guo-Jun Wang
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Zhengzhou University, 1 Jianshe Road, Zhengzhou, 450052, China.
| | - Bu-Lang Gao
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Zhengzhou University, 1 Jianshe Road, Zhengzhou, 450052, China
| | - Rui-Xin Li
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Zhengzhou University, 1 Jianshe Road, Zhengzhou, 450052, China
| | - Jing-Tao Wang
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Zhengzhou University, 1 Jianshe Road, Zhengzhou, 450052, China
| |
Collapse
|
7
|
Zhou Q, Hu Y, Chen X, He S, Zhou X. The application of a robotic single-incision plus one-port laparoscopic total colectomy with fascia space priority for slow-transit constipation - A video vignette. Colorectal Dis 2022; 25:824-825. [PMID: 36324220 DOI: 10.1111/codi.16403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 09/13/2022] [Accepted: 10/22/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Qiyang Zhou
- Department of General Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - You Hu
- Department of General Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Xin Chen
- Department of General Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Songbing He
- Department of General Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Xiaojun Zhou
- Department of General Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| |
Collapse
|
8
|
Liu K, Yan F. Advances in surgical treatment of dolichocolon. Shijie Huaren Xiaohua Zazhi 2022; 30:743-747. [DOI: 10.11569/wcjd.v30.i17.743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Slow transit constipation (STC) is a common disease with an increasing incidence in recent years. Studies have shown that dolichocolon is the most common cause of STC. For patients with severe symptoms, the effect of medical treatment is unsatisfactory, and most patients need surgical treatment. Through comparison, our team found that subtotal colon colectomy is an ideal surgical method for the treatment of STC caused by dolichocolon, and the operation can significantly improve the patient's defecation. In addition, the application of laparoscopic natural orifice specimen extraction surgery to subtotal colon colectomy effectively reduces postoperative complications, shortens hospital stay, and improves patient satisfaction. Future deep clinical research of STC can promote the improvement of the overall level of its diagnosis and treatment.
Collapse
Affiliation(s)
- Kai Liu
- Department of Gastrointestinal Surgery, The Affiliated Zhongshan Hospital, Xiamen University, Xiamen 361004, Fujian Province, China
| | - Feng Yan
- Department of Gastrointestinal Surgery, The Affiliated Zhongshan Hospital, Xiamen University, Xiamen 361004, Fujian Province, China
| |
Collapse
|
9
|
Yu L, Yang X, Guan W, Zhang D, Ren S, Xing Y, An D, Zhang J, Zhu Y, Zhu A. Analysis of Key Genes for Slow Transit Constipation Based on RNA Sequencing. Int J Gen Med 2022; 15:7569-7579. [PMID: 36199586 PMCID: PMC9528044 DOI: 10.2147/ijgm.s380208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 09/16/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose This study aims to identify key genes in slow transit constipation (STC). We also sought to explore the potential link between STC and colorectal cancer. Patients and Methods mRNA expression profiles were obtained by RNA sequencing, and differentially expressed genes were identified. Functional enrichment analysis and a protein–protein interaction (PPI) network was explored, and differentially expressed genes common to STC and colorectal cancer were examined. Analysis of the effect of constipation and colorectal cancer common genes on the overall survival of colorectal cancer patients based on GEPIA database. Results Functional enrichment showed that significantly different genes are related to lymphocyte chemotaxis, positive regulation of inflammatory response, cellular response to tumor necrosis factor, extracellular region, extracellular space and chemokine activity. The hub gene for STC was found in the PPI network. In addition, AQP8 and CFD were common differential genes for STC and colorectal cancer. AQP8 affects overall survival in patients with colorectal cancer. Conclusion Our findings will contribute to understanding the pathology of STC at the molecular level, with the first discovery that AQP8 may be a hub gene in the transition from STC to colorectal cancer.
Collapse
Affiliation(s)
- Linfeng Yu
- Department of General Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, People’s Republic of China
| | - Xiuding Yang
- Department of General Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, People’s Republic of China
| | - Wenlong Guan
- Department of General Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, People’s Republic of China
| | - Dongxu Zhang
- Department of General Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, People’s Republic of China
| | - Shuo Ren
- Department of Gastrointestinal Surgery, Sichuan Cancer Hospital, Chengdu, People’s Republic of China
| | - Yanwei Xing
- Department of General Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, People’s Republic of China
| | - Da An
- Department of Anesthesiology, The First Affiliated Hospital of Harbin Medical University, Harbin, People’s Republic of China
| | - Jian Zhang
- Department of General Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, People’s Republic of China
| | - Yuekun Zhu
- Department of General Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, People’s Republic of China
| | - Anlong Zhu
- Department of General Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, People’s Republic of China
- Correspondence: Anlong Zhu, Department of General Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, People’s Republic of China, Tel/Fax +86 13504848555, Email
| |
Collapse
|
10
|
Perivoliotis K, Baloyiannis I, Tzovaras G. Cecorectal (CRA) versus ileorectal (IRA) anastomosis after colectomy for slow transit constipation (STC): a meta-analysis. Int J Colorectal Dis 2022; 37:531-539. [PMID: 35020001 DOI: 10.1007/s00384-022-04093-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/04/2022] [Indexed: 02/04/2023]
Abstract
INTRODUCTION We conducted this meta-analysis, to compare cecorectal (CRA) and ileorectal anastomosis (IRA), regarding perioperative safety and efficacy, in patients submitted to colectomy for refractory slow transit constipation (STC). METHODS This study followed the Cochrane Handbook for Systematic Reviews of Interventions and the PRISMA guidelines. To identify all eligible records, a systematic literature search in the electronic scholar databases (Medline, Scopus, Web of Science) was performed. RESULTS Overall, 5 trials and 291 patients were included in this meta-analysis. Pooled comparisons confirmed the comparability of the two techniques regarding perioperative complications (p = 0.55). CRA was associated with a shorter operation (p = 0.0004) and hospitalization duration (p = 0.001). Although there was no difference in terms of gastrointestinal symptoms, functional outcomes, and patient satisfaction, CRA resulted in lower long-term Wexner scores (p < 0.0001). CONCLUSION Due to several study limitations, further large-scale RCTs are required to verify the findings of the present meta-analysis.
Collapse
Affiliation(s)
- Konstantinos Perivoliotis
- Department of Surgery, General Hospital of Volos, Polymeri 134, Volos, 38222, Greece. .,Viopolis, University of Thessaly, Larissa, 41500, Greece.
| | - Ioannis Baloyiannis
- Department of Surgery, Mezourlo, University Hospital of Larissa, Larissa, 41110, Greece
| | - George Tzovaras
- Department of Surgery, Mezourlo, University Hospital of Larissa, Larissa, 41110, Greece
| |
Collapse
|
11
|
Colorectal surgery for functional bowel disorders. J Visc Surg 2022; 159:S35-S39. [DOI: 10.1016/j.jviscsurg.2021.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
12
|
Zhang S, Wang R, Li D, Zhao L, Zhu L. Role of gut microbiota in functional constipation. Gastroenterol Rep (Oxf) 2021; 9:392-401. [PMID: 34733524 PMCID: PMC8560038 DOI: 10.1093/gastro/goab035] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 05/06/2021] [Accepted: 07/18/2021] [Indexed: 12/19/2022] Open
Abstract
Functional constipation (FC) is common, yet the etiology is not clear. Accumulating evidence suggests an association between FC and abnormal gut microbiota. The relationship between the gut microbiota and the gut transit is likely bidirectional. This review summarizes the current evidence regarding the impact of gut microbiota on the pathogenesis of FC. By modulating the colonic motility, secretion, and absorption, gut microbiota may contribute to the development of FC through microbial metabolic activities involving bile acids, short-chain fatty acids, 5-hydroxytryptamine, and methane. In support of the key roles of the gut microbiota in FC, treatment with probiotics, prebiotics, synbiotics, and traditional Chinese medicine often result in compositional and functional changes in the gut microbiota. Further studies on the pathogenesis of FC and the therapeutic mechanism of microecological agents will provide a knowledge base for better management of FC.
Collapse
Affiliation(s)
- Shengsheng Zhang
- Digestive Disease Center, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, P. R. China
| | - Ruixin Wang
- Digestive Disease Center, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, P. R. China
| | - Danyan Li
- Digestive Disease Center, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, P. R. China
| | - Luqing Zhao
- Digestive Disease Center, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, P. R. China
| | - Lixin Zhu
- Department of Colorectal Surgery, Guangdong Institute of Gastroenterology, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, P. R. China
| |
Collapse
|
13
|
Annicchiarico A, Dalmonte G, Cecconi S, Valente M, Marchesi F. Laparoscopic subtotal colectomy with antiperistaltic caecorectal anastomosis in severe slow transit constipation - a video vignette. Colorectal Dis 2021; 23:557-559. [PMID: 33222344 DOI: 10.1111/codi.15453] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 10/14/2020] [Accepted: 11/11/2020] [Indexed: 02/08/2023]
Affiliation(s)
- Alfredo Annicchiarico
- Division of General Surgery, Department of Medicine and Surgery, Parma University Hospital, Parma, Italy
| | - Giorgio Dalmonte
- Division of General Surgery, Department of Medicine and Surgery, Parma University Hospital, Parma, Italy
| | - Sara Cecconi
- Division of General Surgery, Department of Medicine and Surgery, Parma University Hospital, Parma, Italy
| | - Marina Valente
- Division of General Surgery, Department of Medicine and Surgery, Parma University Hospital, Parma, Italy
| | - Federico Marchesi
- Division of General Surgery, Department of Medicine and Surgery, Parma University Hospital, Parma, Italy
| |
Collapse
|
14
|
Xie Y, Fan Y, Fan W, Yang X, Xiang Y, Zhao T. Application effect of catgut-embedding therapy combined with minimally invasive surgery for slow transit constipation: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e21875. [PMID: 32871914 PMCID: PMC7458268 DOI: 10.1097/md.0000000000021875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Catgut-embedding therapy combined with minimally invasive surgery has been used for treating slow transit constipation (STC) widely. However, the application effect of catgut-embedding therapy combined with minimally invasive surgery for STC are unclear. This study aims to evaluate the application effect of catgut-embedding therapy combined with minimally invasive surgery for STC. METHODS Randomized controlled trials of catgut-embedding therapy combined with minimally invasive surgery in the treatment of STC will be searched in PubMed, EMbase, Cochrane Library, Web of Science, China National Knowledge Infrastructure, WanFang, the Chongqing VIP Chinese Science and Technology Periodical Database, and China biomedical literature database from inception to July, 2020. And Baidu Scholar, Google Scholar, International Clinical Trials Registry Platform, and Chinese Clinical Trials Registry will be searched to obtain more relevant studies comprehensively. Two researchers will perform data extraction and risk of bias assessment independently. Statistical analysis will be conducted in RevMan 5.3. RESULTS This study will summarize the present evidence by exploring the application effect of catgut-embedding therapy combined with minimally invasive surgery in the treatment of STC. CONCLUSIONS The findings of the study will provide helpful evidence for the application effect of catgut-embedding therapy combined with minimally invasive surgery in the treatment of STC, facilitating clinical practice and further scientific studies. ETHICS AND DISSEMINATION The private information from individuals will not publish. This systematic review also will not involve endangering participant rights. Ethical approval is not required. The results may be published in a peer-reviewed journal or disseminated in relevant conferences. OSF REGISTRATION NUMBER DOI 10.17605/OSF.IO/7HVZB.
Collapse
Affiliation(s)
- Yanpeng Xie
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu610072, Sichuan province
| | - Yihua Fan
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine
| | - Wei Fan
- Tianjin University of Traditional Chinese Medicine, Tianjin
| | - Xiangdong Yang
- Chengdu Anorectal Hospital, Chengdu, Sichuan Province, China
| | - Yanfei Xiang
- Chengdu Anorectal Hospital, Chengdu, Sichuan Province, China
| | - Tianyu Zhao
- Tianjin University of Traditional Chinese Medicine, Tianjin
| |
Collapse
|