HEFT Repository

Surgery for constipation: systematic review and practice recommendations: Graded practice and future research recommendations.

Knowles, C H and Grossi, U and Horrocks, E J and Pares, D and Vollebregt, P F and Chapman, M and Brown, S and Mercer-Jones, M and Williams, A B and Yiannakou, Y and Hooper, R J and Stevens, N and Mason, J (2017) Surgery for constipation: systematic review and practice recommendations: Graded practice and future research recommendations. Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland, 19 Sup. pp. 101-113. ISSN 1463-1318. This article is available to all HEFT staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their HEFT Athens login IDs

Full text not available from this repository.
Official URL: http://onlinelibrary.wiley.com/doi/10.1111/codi.13...

Abstract

AIM

This manuscript forms the final of seven that address the surgical management of chronic constipation (CC) in adults. The content coalesces results from the five systematic reviews that precede it and of the European Consensus process to derive graded practice recommendations (GPR).

METHODS

Summary of review data, development of GPR and future research recommendations as outlined in detail in the 'introduction and methods' paper.

RESULTS

The overall quality of data in the five reviews was poor with 113/156(72.4%) of included studies providing only level IV evidence and only four included level I RCTs. Coalescence of data from the five procedural classes revealed that few firm conclusions could be drawn regarding procedural choice or patient selection: no single procedure dominated in addressing dynamic structural abnormalities of the anorectum and pelvic floor with each having similar overall efficacy. Of one hundred 'prototype' GPRs developed by the clinical guideline group, 85/100 were deemed 'appropriate' based on the independent scoring of a panel of 18 European experts and use of RAND-UCLA consensus methodology. The remaining 15 were all deemed uncertain. Future research recommendations included some potential RCTs but also a strong emphasis on delivery of large multinational high-quality prospective cohort studies.

CONCLUSION

While the evidence base for surgery in CC is poor, the widespread European consensus for GPRs is encouraging. Professional bodies have the opportunity to build on this work by supporting the efforts of their membership to help convert the documented recommendations into clinical guidelines.

Item Type: Article
Additional Information: This article is available to all HEFT staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their HEFT Athens login IDs
Subjects: WI Digestive system. Gastroenterology
WO Surgery
Divisions: Planned IP Care > General Surgery
Related URLs:
Depositing User: Mrs Yolande Brookes
Date Deposited: 23 Nov 2017 16:06
Last Modified: 23 Nov 2017 16:06
URI: http://www.repository.heartofengland.nhs.uk/id/eprint/1501

Actions (login required)

View Item View Item