Background/Objective: In the late's 90' a new surgical treatment, the stapled trans-anal rectal resection (STARR) was born to treat obstructed defecation syndrome (ODS). In this study we retrospectively analyze a series of 450 cases that underwent STARR in 10 years. Methods: Between January 2001 to December 2011, 450 patients, diagnosed with ODS syndrome caused by rectocele or intussusception, underwent to STARR procedure. The presence of rectocele and/or intussusception was verified by dynamic defecography. The preoperative evaluation was completed with anorectal manometry and colonoscopy. Follow-up visits were scheduled 1 week, 1 month, 3 months, 1 years, 3 years and 5 years after surgery. Results: Mean operative time was 30,2 min. In 408 cases (90.7%) hospital discharge occurred 24 hours after surgery. Among postoperative complications urinary retention was observed in 35 patients (7.8%). Five (1.1%) patients presented an early rectal bleeding and 8 (1.8%) patients presented a late bleeding. In 5 (1.1%) patients a stable pelvic hematoma was found. Six (1.3%) patients presented pelvic sepsis due to subperitoneal perforation. An asymptomatic partial dehiscence of stapler row occurred in 19 patients (4.2%).125 patients (27.8%) reported defecation urgency that completely vanished at 3 months follow-up in 83 patients (66,4%) and in further 42 patients (33,6%) at 6-months. The average preoperative ODS score was 14.1; 3.1 at one year; 4.3 at 3 years and 6.4 after five years. Conclusions: In expert hands, with right indications, STARR procedure is safe with good results in terms of improvement of the ODS score

Guttadauro, A., Chiarelli, M., Maternini, M., Baini, M., Pecora, N., & Gabrielli, F. (2018). Value and limits of stapled transanal rectal repair for obstructed defecation syndrome: 10 years-experience with 450 cases. ASIAN JOURNAL OF SURGERY, 41(6), 573-577 [10.1016/j.asjsur.2017.05.002].

Value and limits of stapled transanal rectal repair for obstructed defecation syndrome: 10 years-experience with 450 cases

GUTTADAURO, ANGELO
Primo
;
BAINI, MELISSA;PECORA, NICOLETTA
Penultimo
;
GABRIELLI, FRANCESCO
Ultimo
2018

Abstract

Background/Objective: In the late's 90' a new surgical treatment, the stapled trans-anal rectal resection (STARR) was born to treat obstructed defecation syndrome (ODS). In this study we retrospectively analyze a series of 450 cases that underwent STARR in 10 years. Methods: Between January 2001 to December 2011, 450 patients, diagnosed with ODS syndrome caused by rectocele or intussusception, underwent to STARR procedure. The presence of rectocele and/or intussusception was verified by dynamic defecography. The preoperative evaluation was completed with anorectal manometry and colonoscopy. Follow-up visits were scheduled 1 week, 1 month, 3 months, 1 years, 3 years and 5 years after surgery. Results: Mean operative time was 30,2 min. In 408 cases (90.7%) hospital discharge occurred 24 hours after surgery. Among postoperative complications urinary retention was observed in 35 patients (7.8%). Five (1.1%) patients presented an early rectal bleeding and 8 (1.8%) patients presented a late bleeding. In 5 (1.1%) patients a stable pelvic hematoma was found. Six (1.3%) patients presented pelvic sepsis due to subperitoneal perforation. An asymptomatic partial dehiscence of stapler row occurred in 19 patients (4.2%).125 patients (27.8%) reported defecation urgency that completely vanished at 3 months follow-up in 83 patients (66,4%) and in further 42 patients (33,6%) at 6-months. The average preoperative ODS score was 14.1; 3.1 at one year; 4.3 at 3 years and 6.4 after five years. Conclusions: In expert hands, with right indications, STARR procedure is safe with good results in terms of improvement of the ODS score
Articolo in rivista - Articolo scientifico
Obstructed defecation; Rectal mucosal prolapse; Rectocele; Trans-anal rectal resection; Urgency
English
573
577
5
Guttadauro, A., Chiarelli, M., Maternini, M., Baini, M., Pecora, N., & Gabrielli, F. (2018). Value and limits of stapled transanal rectal repair for obstructed defecation syndrome: 10 years-experience with 450 cases. ASIAN JOURNAL OF SURGERY, 41(6), 573-577 [10.1016/j.asjsur.2017.05.002].
Guttadauro, A; Chiarelli, M; Maternini, M; Baini, M; Pecora, N; Gabrielli, F
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/161070
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