[Surgical treatment for intractable constipation: selection of procedure and perioperative management].

Abstract

When chronic constipation develops to the stage of intractable constipation, the symptoms of constipation in patients are severe and persistent, and drug treatment is often ineffective, so surgical treatment is often considered. The clinical manifestations of patients with intractable constipation are variable, and the underlying pathophysiological changes involve various abnormal and dysfunctional anatomical structure of colorectal and pelvic floor, which are different. For the surgical treatment of intractable constipation, accurate preoperative classification diagnosis is very important, and it is necessary to formulate an exact and effective surgical plan to avoid untargeted empirical treatment. The key to maintain long-term good results after surgery is to carry out comprehensive and scientific preoperative evaluation and the correct choice of individual operation. In recent years, thanks to the progress of basic research and clinical diagnosis and treatment of intractable constipation, as well as the improvement of minimally invasive surgical techniques and perioperative management, the safety and effectiveness of surgical treatment have been significantly improved. Based on the research progress at home and abroad and the authors' clinical experience, this paper focuses on the contents of preoperative accurate assessment, scientific selection of surgical methods and perioperative intestinal microecological therapy, so as to provide references for clinical practice in the same field.