PMID- 20533038
OWN - NLM
STAT- MEDLINE
DCOM- 20101220
LR  - 20211020
IS  - 1432-2323 (Electronic)
IS  - 0364-2313 (Linking)
VI  - 34
IP  - 9
DP  - 2010 Sep
TI  - Disappointing long-term outcomes after stapled transanal rectal resection for 
      obstructed defecation.
PG  - 2191-6
LID - 10.1007/s00268-010-0638-6 [doi]
AB  - BACKGROUND: The aim of this study was to assess both short and long-term 
      functional outcomes and the quality of life of patients treated with stapled 
      transanal rectal resection (STARR) for obstructed defecation syndrome (ODS). 
      METHODS: Forty-six patients with ODS as a result of rectocele and/or rectal 
      intussusceptions were treated with STARR. Data collected included demographics, 
      OR time, pain score using a visual analog scale (VAS), and complications. The 
      study included defecographic assessment and anal manometry [urge-to-defecate 
      volume (UTDV) and maximum tolerable volume (MTV)], both done preoperatively and 1 
      year postoperatively. A modified obstructed-defecation syndrome questionnaire 
      (MODS), constipation quality of life (PAC-QOL) score, and CCF continence score 
      were all recorded preoperatively and every 6 months during follow-up. RESULTS: 
      Mean age of the patients was 48.4 years. Forty-five patients had mild 
      postoperative pain (VAS = 1-2). Only one male patient had severe pain (VAS = 7). 
      Three patients developed stenosis at the staple line 6 months after surgery and 
      were dilated manually. Follow-up ranged from 18 to 48 months and the median 
      follow-up was 42 months. The recurrence rate was 6.5% after 18 months, 10.8% 
      after 36 months, and 13% after 42 months. Significant reduction in MTV and UTDV 
      was recorded. MODS and PAC-QOL showed significant improvement after 6 months; 
      this improvement was maintained for 18 months and then there was a rapid decline 
      until the end of the follow-up period. CONCLUSIONS: STARR is a safe surgical 
      procedure that effectively restores the anatomy and function of the anorectum in 
      patients with ODS. This correction improves functional and QOL scores; however, a 
      high rate of symptomatic recurrence and QOL score decline are expected after 18 
      months.
FAU - Madbouly, Khaled M
AU  - Madbouly KM
AD  - Department of Surgery, University of Alexandria, El Raml Station, Alexandria, 
      Egypt. Khaled.Madbouly@alexmed.edu.eg
FAU - Abbas, Khaled S
AU  - Abbas KS
FAU - Hussein, Ahmed M
AU  - Hussein AM
LA  - eng
PT  - Journal Article
PL  - United States
TA  - World J Surg
JT  - World journal of surgery
JID - 7704052
SB  - IM
MH  - Adult
MH  - Aged
MH  - Constipation/*surgery
MH  - Defecation
MH  - *Digestive System Surgical Procedures/methods
MH  - Female
MH  - Humans
MH  - Intestinal Obstruction/*surgery
MH  - Male
MH  - Middle Aged
MH  - Quality of Life
MH  - Recovery of Function
MH  - Rectum/*surgery
MH  - Surgical Stapling
MH  - Syndrome
MH  - Treatment Outcome
EDAT- 2010/06/10 06:00
MHDA- 2010/12/21 06:00
CRDT- 2010/06/10 06:00
PHST- 2010/06/10 06:00 [entrez]
PHST- 2010/06/10 06:00 [pubmed]
PHST- 2010/12/21 06:00 [medline]
AID - 10.1007/s00268-010-0638-6 [doi]
PST - ppublish
SO  - World J Surg. 2010 Sep;34(9):2191-6. doi: 10.1007/s00268-010-0638-6.