Zhonghua Wei Chang Wai Ke Za Zhi. 2022 Dec 25;25(12):1045-1057. doi: 10.3760/cma.j.cn441530-20221009-00404.
In recent years, professional societies in China including the Chinese Medical Doctor Association Anorectal Branch have issued many clinical practice guidelines and expert consensus on constipation, which played a positive role in the standardization of diagnosis and surgical treatment of chronic constipation in China. However, the diagnosis and treatment of outlet obstructive constipation (OOC) remain controversial. OOC, the most common subtype of functional constipation, is featured by various clinical symptoms, complex pelvic floor anatomy, functional and psychological aspects. We need a gold standard supported by high-level clinical research evidence. To standardize the diagnosis and treatment process of OOC in China, Chinese Medical Doctor Association Anorectal Branch and its Clinical Guidelines Committee, and jointly sponsored by Professional Committee on Anorectal Diseases of Chinese Society of Integrated Traditional Chinese and Western Medicine, Anorectal Disease Committee of Chinese Medical Women's Association and Chinese Constipation Medical Association, and the organized and summoned a Chinese expert taskforce to focus on OOC diagnosis, classification, examination, evaluation, and various treatments (e.g. diet modification, medication, biofeedback therapy, pelvic floor function training, psychological intervention, traditional Chinese medicine and surgical treatment). Based on the latest relevant evidence in China and abroad and experts' clinical experience, the taskforce produced the " Chinese expert consensus on the diagnosis and treatment of outlet obstructive constipation (2022 edition)" after rounds of discussion and revision. The aim is to help anorectal surgeons make clinical decisions, standardize the process of diagnosis and treatment, reduce complications and improve clinical efficacy in OOC.
近年来,包括中国医师协会肛肠分会在内的中国专业学会发布了许多关于便秘的临床实践指南和专家共识,这对中国慢性便秘的诊断和外科治疗的规范化起到了积极作用。然而,出口梗阻型便秘(OOC)的诊断和治疗仍存在争议。OOC是功能性便秘最常见的亚型,具有多种临床症状、复杂的盆底解剖结构以及功能和心理方面的特点。我们需要一个有高水平临床研究证据支持的金标准。为规范中国OOC的诊断和治疗流程,中国医师协会肛肠分会及其临床指南委员会,联合中国中西医结合学会肛肠专业委员会、中国女医师协会肛肠专业委员会以及中国便秘医学会共同组织并召集了一个中国专家工作组,重点关注OOC的诊断、分类、检查、评估以及各种治疗方法(如饮食调整、药物治疗、生物反馈治疗、盆底功能训练、心理干预、中医治疗和手术治疗)。基于国内外最新的相关证据以及专家的临床经验,工作组经过多轮讨论和修订后制定了《出口梗阻型便秘诊断和治疗中国专家共识(2022版)》。目的是帮助肛肠外科医生做出临床决策,规范诊断和治疗流程,减少并发症并提高OOC的临床疗效。