Publication Name	World Journal of Gastrointestinal Surgery
Manuscript ID	116100
Country	Italy

Category	Surgery
Manuscript Type	Opinion Review
Article Title	Beyond stapled transanal rectal resection vs ventral rectopexy dichotomy: Toward a phenotype-guided surgical paradigm for obstructed defecation syndrome
Manuscript Source	Invited Manuscript
All Author List	Michele Schiano di Visconte and Sonia Sarnari
Funding Agency and Grant Number
Corresponding Author	Michele Schiano di Visconte, Chief, MD, PhD, Colorectal and Pelvic Floor Diseases Center, Department of General Surgery, Azienda ULSS2 “Marca Trevigiana”, Via Sant’Ambrogio in Fiera 37, Treviso 31100, Veneto, Italy. mschianodivisconte@gmail.com
Key Words	Obstructed defecation syndrome; Stapled transanal rectal resection; Ventral rectopexy; Phenotype-guided surgery; Pelvic floor disorders; Multidisciplinary management; Functional constipation; Patient stratification
Core Tip	The management of obstructed defecation syndrome must evolve beyond the suboptimal dichotomy of stapled transanal rectal resection vs ventral rectopexy. This review advocates for a fundamental paradigm shift toward a phenotype-guided stratified treatment algorithm. Mandatory preoperative phenotyping, integrating advanced imaging and high-resolution anorectal manometry, is crucial for classifying patients into distinct structural and functional subtypes. This personalized approach optimizes patient selection and yields superior, durable functional outcomes, thereby establishing a new framework for precision pelvic floor surgery.
Citation	Schiano di Visconte M, Sarnari S. Beyond stapled transanal rectal resection vs ventral rectopexy dichotomy: Toward a phenotype-guided surgical paradigm for obstructed defecation syndrome. World J Gastrointest Surg 2025; In press

Received	2025-11-02 11:49
Peer-Review Started	2025-11-02 11:49
First Decision by Editorial Office Director	2025-11-14 04:46
Return for Revision	2025-11-14 04:46
Revised	2025-11-18 19:40
Publication Fee Transferred
Second Decision by Editor	2025-12-11 02:46
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2025-12-11 05:56
Articles in Press	2025-12-11 05:56
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	1948-9366 (online)
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