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
8-lug-2017
2018
41
6
573
577
30189-6
open
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].
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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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