Surgical strategy of outlet obstructive constipation                     WANG Zhen-jun, YANG Xin-qing. Department of General Surgery, Chaoyang Hospital Affiliated to Capital Medical University, Beijing 100020, China
Corresponding author：WANG Zhen-jun, E-mail: wang3zj@sohu.com
Abstract    Outlet obstructive constipation is observed in approximately half of all patients with functional constipation. Typical symptoms are laborious incomplete and fragmented evacuation in conjunction with heavy straining. The duration of defecation is almost prolonged. Although the symptomatology has been well defined in the literature, the pathophysiology and etiology are still poorly understood. Outlet obstruction is a complex disorder which includes also psychosomatic factors and temporary anatomical obstruction. Currently, evaluation includes detailed history and rectal and pelvic exam together with physiologic tests such as anorectal manometry, balloon expulsion test, defecography, and dynamic MRI. The treatment of OOC has an established place within the field of conservative therapy. The selection of patients of the STARR procedure, Bresler procedure and other operative techniques remains important.