Search Results (3)

In this review, we summarize current insights into the treatment of functional constipation (FC) in children. Constipation is a global issue in the pediatric population, with a prevalence of approximately 9.5%. Initial management involves a combination of non-pharmacological and pharmacological interventions. However, a significant number of children continue to experience therapy-resistant FC despite optimal non-pharmacological and pharmacological treatments. While studies on novel pharmacological options in children are limited, adult trials have shown promising results. New agents such as lubiprostone, prucalopride, linaclotide, and plecanatide have demonstrated improved outcomes compared to placebo or conventional therapies, particularly in increasing spontaneous bowel movements. Neurostimulation presents an additional treatment modality. Posterior tibial nerve stimulation appears to be a promising new option, offering high treatment satisfaction and a favorable safety profile with a low rate of severe adverse events. For children who do not respond to optimal conservative therapy, the impact on quality of life can be substantial. In such cases, surgical interventions may be considered, including intrasphincteric botulinum toxin injections, antegrade continence enema surgery, and, in severe cases, colonic resection or a diverting ostomy. The choice of surgical treatment remains a subject of ongoing debate. Therapy-resistant FC in children is a complex and impactful condition. An individualized, stepwise approach is essential, with surgical options such as colonic resection reserved as a last resort. Full article

Rectal cancer surgery has undergone transformative advancements over the past few decades, evolving from radical, high-morbidity procedures to more refined techniques focused on both oncological outcomes and the preservation of anorectal function. This review provides a brief overview of the history of rectal cancer surgery, highlighting key innovations in imaging, neoadjuvant therapy, and minimally invasive techniques that have significantly reduced the need for permanent and temporary ostomies. Additionally, the current indications for both permanent and temporary ostomies are reviewed, including a discussion of associated complications, such as non-reversal, parastomal hernias, stomal prolapse, stenosis, and skin-related issues, along with strategies and techniques to mitigate these complications. This review underscores the importance of ongoing innovation and individualized surgical planning to enhance patient outcomes in rectal cancer care by understanding the historical context, contemporary practices, and associated challenges. Full article

Background/Objectives: Abdominal ostomy surgery has a severe impact on individuals’ daily lives. These procedures are typically indicated for conditions such as cancer, inflammatory bowel disease, or traumatic injuries. They involve creating an artificial opening, denominated the stoma, in the abdominal area to divert feces or urine, establishing a connection between the affected organs and the body’s exterior. Thus, specialized products to collect the body fluids are required, being effective and tailored products crucial to enhance the quality of life of such patients. Methods: This paper presents a review of fecal fluid collection devices and advanced technologies designed to assist patients with ostomies. The study aims to identify the known bags/devices and evaluate their attributed performance in enhancing the population’s physical and social quality of life. This review is based on a systematic search conducted between 20 February and 2 March 2024, in the PubMed, Scopus, Web of Science, Google Scholar, and Google Patents databases. Articles published within the last eight years from this period were included in the analysis. Results: The devices found in the study were classified as passive, requiring active monitoring by the user, and active, providing automated assistance. Three main categories were identified, reflecting the most significant concerns of patients: (1) devices that control fluid leakage, reducing peristomal dermatological problems; (2) devices that minimize odors and noise, reducing social embarrassment; and (3) devices that monitor fluid volume, helping with electrolyte balance, especially in patients with ileostomies. Conclusions: This study revealed that the existing devices meet primary collection and disposal needs. However, introducing smart devices could offer greater control and confidence to users, providing real-time information on gas pressure, stool texture, and accumulated volume. Thus, overall, the development of advanced technologies can significantly improve patients’ quality of life, restore social confidence, and enable a more effective management of the condition by sharing information with medical teams. Full article