Background This study aims to establish a consensus-based standard protocol for transanal irrigation (TAI) in patients with low anterior resection syndrome (LARS) and functional constipation.MethodsThe Delphi method was utilized to reach a consensus among clinicians and nurses expert in the field of colorectal surgery and gastroenterology. To address various uncertainties concerning technical aspects, difficulties, and prescription of TAI, two questionnaires were developed and analyzed in two rounds. A binary approach was employed, setting a consensus threshold of 75% agreement.ResultsIn the first round, nurses achieved consensus on all statements, while clinicians required a second round to reach consensus, particularly regarding prescription and technical aspects. Clinicians reached consensus on prescribing TAI as a second-line treatment for LARS and functional constipation, following the failure of conservative measures such as dietary and lifestyle interventions. Timing considerations for patients with LARS encompass avoiding TAI within 1 month of stoma closure and waiting a minimum of 3 months. For functional constipation, TAI is recommended for slow transit constipation, emphasizing its preference over surgical options. Consensus was also reached on the choice of catheter for patients with LARS, training requirements for patients and caregivers, preparation of the patient's intestine before TAI, and recommended irrigations.ConclusionsThis consensus study successfully developed a standardized TAI protocol for LARS and functional constipation. It provides comprehensive guidelines for prescription and technical aspects, addressing the challenges encountered by healthcare professionals. The protocol aims to enhance patient care, improve treatment outcomes, and contribute to the advancement of TAI.
Consensus-driven protocol for transanal irrigation in patients with low anterior resection syndrome and functional constipation / Martellucci, J.; Falletto, E.; Ascanelli, S.; Bondurri, A.; Borin, S.; Bottini, C.; Caproli, E.; Carrera, M.; Cestaro, G.; Chimisso, L.; Clarizia, G.; Clementi, I.; Cornaglia, S.; Costa, S.; Gallo, G.; Guerci, C.; Lambiase, C.; Lauretta, A.; Luffarelli, P.; Neri, M. C.; Piccolo, D.; Rosati, E.; Rossitti, P.; Spolini, A.; Torchia, G.; Valloncini, E.; Zattoni, D.; Zucchi, E.; Biotti, P.; Cambareri, A.; Coniglio, G.; Coppola, A.; Nepote Fus, K.; Graziani, S.; Grilli, M.; Grego, A.; Guerra, E.; Livio, E.; Manganini, L.; Mazzeo, P.; Minonne, A.; Mirafiori, M.; Negri, G.; Palazzolo, V.; Di Pasquale, C.; Tantolo, V.. - In: TECHNIQUES IN COLOPROCTOLOGY. - ISSN 1123-6337. - 28:1(2024). [10.1007/s10151-024-03033-y]
Consensus-driven protocol for transanal irrigation in patients with low anterior resection syndrome and functional constipation
Clementi, I.;Gallo, G.;Coppola, A.;
2024
Abstract
Background This study aims to establish a consensus-based standard protocol for transanal irrigation (TAI) in patients with low anterior resection syndrome (LARS) and functional constipation.MethodsThe Delphi method was utilized to reach a consensus among clinicians and nurses expert in the field of colorectal surgery and gastroenterology. To address various uncertainties concerning technical aspects, difficulties, and prescription of TAI, two questionnaires were developed and analyzed in two rounds. A binary approach was employed, setting a consensus threshold of 75% agreement.ResultsIn the first round, nurses achieved consensus on all statements, while clinicians required a second round to reach consensus, particularly regarding prescription and technical aspects. Clinicians reached consensus on prescribing TAI as a second-line treatment for LARS and functional constipation, following the failure of conservative measures such as dietary and lifestyle interventions. Timing considerations for patients with LARS encompass avoiding TAI within 1 month of stoma closure and waiting a minimum of 3 months. For functional constipation, TAI is recommended for slow transit constipation, emphasizing its preference over surgical options. Consensus was also reached on the choice of catheter for patients with LARS, training requirements for patients and caregivers, preparation of the patient's intestine before TAI, and recommended irrigations.ConclusionsThis consensus study successfully developed a standardized TAI protocol for LARS and functional constipation. It provides comprehensive guidelines for prescription and technical aspects, addressing the challenges encountered by healthcare professionals. The protocol aims to enhance patient care, improve treatment outcomes, and contribute to the advancement of TAI.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
