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Review
. 2024 Nov 11;28(1):153.
doi: 10.1007/s10151-024-03033-y.

Consensus-driven protocol for transanal irrigation in patients with low anterior resection syndrome and functional constipation

J Martellucci  1 , E Falletto  2 , S Ascanelli  3 , A Bondurri  4 , S Borin  5 , C Bottini  6 , E Caproli  7 , M Carrera  8 , G Cestaro  9 , L Chimisso  10 , G Clarizia  11 , I Clementi  12 , S Cornaglia  13 , S Costa  14 , G Gallo  15 , C Guerci  16 , C Lambiase  17 , A Lauretta  18 , P Luffarelli  19 , M C Neri  20 , D Piccolo  21 , E Rosati  22 , P Rossitti  23 , A Spolini  11 , G Torchia  24 , E Valloncini  25 , D Zattoni  26 , E Zucchi  23 , P Biotti  27 , A Cambareri  2 , G Coniglio  28 , A Coppola  29 , K Nepote Fus  8 , S Graziani  30 , M Grilli  7 , A Grego  13 , E Guerra  31 , E Livio  14 , L Manganini  32 , P Mazzeo  33 , A Minonne  34 , M Mirafiori  18 , G Negri  11 , V Palazzolo  35 , C Di Pasquale  5 , V Tantolo  36
Affiliations
Review

Consensus-driven protocol for transanal irrigation in patients with low anterior resection syndrome and functional constipation

J Martellucci et al. Tech Coloproctol. .

Erratum in

  • Correction: 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, Bellini M, Lambiase C, Lauretta A, Luffarelli P, Neri MC, 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, D'Alba L, Minonne A, Mirafiori M, Negri G, Palazzolo V, Di Pasquale C, Tantolo V. Martellucci J, et al. Tech Coloproctol. 2025 Jan 3;29(1):40. doi: 10.1007/s10151-024-03105-z. Tech Coloproctol. 2025. PMID: 39753936 No abstract available.

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.

Methods: The 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.

Results: In 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.

Conclusions: This 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.

Keywords: Consensus-based protocol; LARS; Peristeen Plus; TAI.

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Conflict of interest statement

Declarations Conflict of interest The authors declare no competing interests.

References

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