Document Detail


Comparative study of Contour Transtar and STARR procedure for the treatment of obstructed defecation syndrome (ODS)--feasibility, morbidity and early functional results.
MedLine Citation:
PMID:  19438882     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: Stapled transanal rectal resection (STARR) is a promising new treatment for obstructed defecation syndrome (ODS). It may be performed using either a double-stapling technique (PPH-STARR) or with the new Contour Transtar (CT) device. The aim of this study was to evaluate the two techniques with respect to morbidity and functional outcomes.
METHOD: Patients presenting with ODS were evaluated using standardized clinical and radiological investigations and prospectively entered into a database. A total of 150 Patients were treated with either PPH-STARR (n = 68) or CT (n = 82) and further evaluated at 12 month postoperatively.
RESULTS: The mean size of the resected specimen was 27 cm(2) (SD +/-4.86 cm(2)) in the PPH-STARR group and 46 cm(2) (SD +/-10.6 cm(2)) in the CT group [P < 0.001]. Morbidity was 7.3% (n = 5) in the PPH-STARR group and 7.5% (n = 6) in the CT group. The most common complication was minor postoperative bleeding in both groups (PPH-STARR: n = 2, 2.9%; CT: n = 2, 2.4%) Overall there were no septic complications and no surgical re-interventions. There was a tendency for more postoperative pain following CT (n = 3, 3.6%) as compared with PPH-STARR (n = 1, 1.4%). Constipation Scores (CCS) were 15.50 +/- 5.71 in the PPH-STARR group and 15.70 +/- 5.84 in the CT group preoperatively and decreased significantly to 8.25 (SD +/-1.45) and 8.01 (SD +/-2.31) 12-months after surgery. Values did not differ significantly between the two groups.
CONCLUSIONS: Contour Transtar is as safe and effective as PPH-STARR and provides a true circumferential resection of rectal intussusception. This may benefit selected patients and result in improved long-term durability of the technique.
Authors:
C Isbert; J Reibetanz; D G Jayne; M Kim; C-T Germer; L Boenicke
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2009-04-29
Journal Detail:
Title:  Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland     Volume:  12     ISSN:  1463-1318     ISO Abbreviation:  Colorectal Dis     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-19     Completed Date:  2010-12-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883611     Medline TA:  Colorectal Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  901-8     Citation Subset:  IM    
Affiliation:
Department of General, Visceral, Vascular & Paediatric Surgery, University Hospital Wuerzburg, Germany. isbert_c@chirurgie.uni-wuerzburg.de
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Cystocele / complications
Feasibility Studies
Female
Follow-Up Studies
Humans
Intestinal Obstruction / etiology,  surgery*
Intussusception / complications,  surgery*
Middle Aged
Recovery of Function*
Rectal Diseases / complications,  surgery*
Rectocele / complications
Surgical Staplers*
Surgical Stapling / adverse effects,  methods*
Syndrome
Comments/Corrections
Comment In:
Colorectal Dis. 2010 Dec;12(12):1274-5   [PMID:  20955510 ]

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