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transanal surgery for obstructed defecation syndrome: Literature review and a single-center experience

World Journal of Gastroenterology 2016年第35期22卷 7983-7998页

作者： 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

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.

关键词： Obstructive defecation syndrome transanal surgery transanal manual technique transanal stapling procedure Medical assessment Clinical outcome Clinical experience

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Introduction of new techniques and technologies in surgery: Where is transanal total mesorectal excision today?

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World Journal of Gastrointestinal surgery 2020年第5期12卷 203-207页

作者： Antonio Caycedo-Marulanda Sunil Patel Shaila Merchant Carl Brown Department of surgery Queen’s University and Kingston General HospitalKingston K7L 2V7OntarioCanada Department of surgery University of British Columbia and St.Paul HospitalVancouver V6Z 1Y6British ColumbiaCanada

The introduction of new surgical techniques and technologies has traditionally been *** many settings surgeons frequently adopt novel procedures without following a structured program of implementation or *** appearance of innovative technology played a pivotal role in the advancement of new surgical techniques during the industrial *** has been an essential component of surgical development,which led to contemporary surgical techniques such as minimally invasive *** initiatives have been developed to guide the safe introduction of new surgical techniques and other *** include comprehensive concepts such as the Idea,Development,Exploration,Assessment,Long-term study framework,which could be particularly relevant when reflecting on the novel transanal total mesorectal excision(taTME),introduced a decade *** relatively novel and complex procedure promised to overcome some of the major limitations of traditional surgical approaches for rectal *** to the Idea,Development,Exploration,Assessment,Long-term study framework,taTME is in the phase of exploration,where there is an existing and increasing number of reports being published as the experience *** current management of rectal cancer is in a state of radical evolution,with multiple options that were not previously *** TME is only one technique amongst many which could be part of a rectal cancer surgeon’s armamentarium;however,it requires further rigorous study and evaluation.

关键词： Rectal cancer New technology Safety Innovation transanal surgery

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