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World Journal of Gastroenterology 2010年第20期16卷 2542-2548页

作者： Zhang, Bin Ding, Jian-Hua Yin, Shu-Hui Zhang, Meng Zhao, Ke Second Artillary Gen Hosp Dept Colon Rectal Surg Beijing 100088 Peoples R China Second Artillary Gen Hosp Dept Lab Med Beijing 100088 Peoples R China

AIM:To evaluate the safety and efficacy of stapled transanal rectal resection(STARR),and to analyze the outcome of the patients 12-mo after the ***:From May 2007 to October 2008,50 female patients with rectocele and/or rectal intussusception underwent *** preoperative status,perioperative and postoperative complications at baseline,3,6 and 12-mo were *** were collected prospectively from standardized questionnaires for the assessment of constipation[constipation scoring system,Longo’s obstructed defecation syndrome(ODS)score system,symptom severity score],patient satisfaction (visual analogue scale),and quality of life(Patient Assessment of Constipation-Quality of Life Questionnaire).RESULTS:At a 12-mo follow-up,significant improvement in the constipation scoring system,ODS score system,symptom severity score,visual analog scale and quality of life(Pobstructed defecation associated with symptomatic rectocele and rectal intussusception.

关键词： Stapled transanal rectal resection obstructed defecation syndrome Rectocele Rectal intussusception

Abdominal ventral rectopexy with colectomy for obstructed defecation syndrome:An alternative option for selected patients

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World Journal of Clinical Cases 2020年第23期8卷 5976-5987页

作者： Li Wang Chun-Xue Li Yue Tian Jing-Wang Ye Fan Li Wei-Dong Tong Department of General Surgery Daping HospitalArmy Medical UniversityChongqing 400042China

BACKGROUND Abdominal ventral rectopexy(AVR)with colectomy is controversial in the treatment of obstructed defecation syndrome(ODS).Literature data on this technique for ODS are very *** To evaluate the safety and efficacy of AVR with colectomy for selected patients with *** Consecutive patients who underwent AVR with colectomy for ODS were identified prospectively from 2016 to 2017 in our *** demographics,perioperative surgical results,and postoperative follow-up outcomes were collected and ***-term follow-up was evaluated with standardized *** severity of symptoms was assessed by the objective Wexner Constipation Score(WCS)and ODS *** quality of life was assessed by the Patients Assessment of Constipation Quality of Life *** outcome was compared pre-and post-operatively for each *** primary outcomes were determined by the improvement in symptoms and quality of *** outcome measures were operating time,postoperative length of stay,morbidity and mortality,improvement of pelvic floor structure,and patient *** Four patients underwent robotic-assisted surgery,and two patients underwent a laparoscopic-assisted *** mean operating time for the robotic approach was 243 min(range 160–300 min),and the mean operating time for the laparoscopic approach was 230 min(range 220-240 min).The mean postoperative length of stay was 8.2 d(range 6-12 d).There was no conversion to open procedure and no postoperative *** urinary retention,wound infection,prolonged ileus,pelvic infection and anastomosis leakage *** patients were followed up for 36 *** WCS,ODS,and Patients Assessment of Constipation Quality of Life score improved significantly postoperatively(P<0.05).The WCS and ODS scores showed the best remission and stabilization at 6 to 12 mo after *** was no recurrence or novel constipation after *** of the patients used laxative

关键词： obstructed defecation syndrome Ventral mesh rectopexy Colectomy Internal rectal prolapse Constipation Laparoscopic resection rectopexy

Prognostic and predictive value of interstitial cells of Cajal populations following stapled transanal rectal resection(STARR)in patients with obstructed defecation syndrome

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Gastroenterology Report 2018年第4期6卷 270-276,I0001,I0002页

作者： Hong-Cheng Lin Hua-Xian Chen Liang Huang Ya-Xi Zhu Qian Zhou Juan Li Yu-Jie Xu Dong-Lin Ren Jian-Ping Wang Department of Colorectal Surgery The Sixth Affiliated Hospital of Sun Yat-sen UniversityGuangzhou510655 GuangdongChina Guangdong Institute of Gastroenterology Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor DiseasesGuangzhou510655 GuangdongChina Department of Pathology The Sixth Affiliated Hospital of Sun Yat-sen UniversityGuangzhouGuangdongChina

Objective:The present study was designed to evaluate the functional outcome of stapled transanal rectal resection(STARR)and to examine the relationship between the population density of the interstitial cells of Cajal(ICC)and the efficacy of the STARR operation in the management of obstructed defecation syndrome(ODS)***:Full-thickness rectal samples were obtained from 50 ODS patients who underwent *** were analysed using ICC *** and functional parameters obtained with defecography and anorectal manometry were compared with 20 ***:ICCs were significantly decreased in patients in the submucosal(SM),intramuscular(IM)andmyenteric(MY)regions when compared with the control group(P<0.05).The mean pre-operative Cleveland Constipation Score(CCS)was 24.264.1,whilst the CCS at 1,2,3,4 and 5 years post-operatively decreased significantly(P<0.05).At 3 post-operative years,58.3%(28/48)of the patients reported a favorable outcome(CCS10).On univariate analysis,the functional results were worse in those with pre-operative digitation(P=0.017),a decreased ICC-MY cell population(P=0.067),a higher resting anal canal pressure(P=0.039)and a higher rectal sensory threshold(P=0.073).Multivariate analysis showed the decreased ICC-MY cell population was an independent predictor for low unfavorable functional outcome(odds ratio=0.097,95%confidence interval:0.012–0.766).Conclusions:STARR achieved acceptable results at the cost of a slight deterioration over amore prolonged *** with a decreased ICC number in the rectal specimen showed an unfavorable functional outcome where pre-operative histological assessment of a full-thickness rectal samplemight predict for the functional outcome following STARR.

关键词： interstitial cells of Cajal obstructed defecation syndrome stapled transanal rectal resection(STARR) functional outcomes

Quantitative proteomics analysis reveals the pathogenesis of obstructed defecation syndrome caused by abnormal expression of dystrophin

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World Journal of Gastroenterology 2024年第45期30卷 4817-4835页

作者： Wen-Zhe Li Yu Xiong Tian-Kun Wang Yan-Yan Chen Song-Lin Wan Lu-Yao Li Meng Xu Jing-Jing Tong Qun Qian Cong-Qing Jiang Wei-Cheng Liu Department of Colorectal and Anal Surgery(Clinical Center for Pelvic Floor Surgery) Clinical Center of Constipation and Pelvic Floor Disease of WuhanHubei Key Laboratory of Intestinal and Colorectal DiseasesClinical Center of Intestinal and Colorectal Diseases of Hubei ProvinceQuality Control Center of Colorectal and Anal Surgery of Health Commission of Hubei ProvinceZhongnan Hospital of Wuhan UniversityWuhan 430071Hubei ProvinceChina Department of Radiation and Medical Oncology for Esophageal Mediastinal and Lymphatic Tumors Zhongnan Hospital of Wuhan UniversityWuhan 430071Hubei ProvinceChina Center for Evidence-Based and Translational Medicine Zhongnan Hospital of Wuhan UniversityWuhan 430071Hubei ProvinceChina Department of Pathology Zhongnan Hospital of Wuhan UniversityWuhan 430071Hubei ProvinceChina School of Life Sciences Central China Normal UniversityWuhan 430071Hubei ProvinceChina

BACKGROUND obstructed defecation syndrome(ODS)represents the most prevalent form of chronic constipation,affecting a diverse patient population,leading to numerous complications,and imposing a significant burden on healthcare *** ODS patients have insufficient rectal propulsion,but the exact mechanism underlying the pathogenesis of ODS remains *** To explore the molecular mechanism underlying the pathogenesis of *** A total of 30 pairs of rectal samples were collected from patients with ODS(ODS group)or grade IV prolapsed hemorrhoids without constipation(control group)for quantitative proteomic and bioinformatic ***,50 pairs of paraffin-embedded rectal specimens were selected for immunohistochemistry and immunofluorescence studies to validate the analysis *** intestinal smooth cell contractile function experiments and electrophysiological experiments were conducted to verify the physiological functions of target *** ultrastructure was detected using transmission electron *** In comparison to the control group,the expression level of dystrophin(DMD)in rectal specimens from ODS patients was markedly *** finding was corroborated using immunohistochemistry and immunofluorescence *** diminished expression of DMD compromised the contractile function of intestinal smooth muscle *** the molecular level,nucleoporin protein 153 and L-type voltage-gated calcium channel were found to be overexpressed in intestinal smooth muscle cells exhibiting downregulated DMD *** experiments confirmed an excessive influx of calcium ions into these ***,vacuolar-like structures which may be associated with excessive calcium influx were observed in the cells by transmission electron *** Decreased DMD expression in intestinal smooth muscle may upregulate L-type voltage-gated calcium channel expression,leading to excessive calcium in

关键词： obstructed defecation syndrome Dystrophin Smooth muscle Contraction Proteomics L-type voltage-gated calcium channel