Document Detail


Long-term outcome after transanal rectal resection in patients with obstructed defecation syndrome.
MedLine Citation:
PMID:  23303154     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Stapled transanal rectal resection with a new, curved, multifire stapler (Transtar procedure) has shown promising short- and midterm results for treating obstructed defecation syndrome. However, few results have been published on long-term outcome.
OBJECTIVE: This study aimed to investigate long-term functional results and quality of life after the Transtar procedure.
DESIGN: This is a retrospective study.
SETTING: This study was conducted at a tertiary hospital in Switzerland.
PATIENTS: Seventy consecutive patients (68 female) with obstructed defecation syndrome had a median age of 65 years (range, 20-90).
INTERVENTION: The Transtar procedure was performed between January 2007 and March 2010.
MAIN OUTCOME MEASURES: Postoperative functional results were evaluated with the Symptom Severity Score, Obstructed Defecation Score, and Cleveland Incontinence Score. Quality of life was evaluated with the Fecal Incontinence Quality of Life Score and the SF-36 Health Survey. Data were divided into 4 groups of 1-, 2-, 3-, and 4-year follow-ups.
RESULTS: The functional scores showed significant postoperative improvement throughout the studied period (p = 0.01). The quality-of-life scores showed a tendency for improvement only in the mental components on the SF-36 Health Survey (p = 0.01). Sixteen patients reported postoperative fecal urgency, but this subsided within a few months. Nine patients reported new postoperative episodes of incontinence and required further treatment.
LIMITATIONS: This study was limited by its retrospective nature, the selection bias, and a bias by the small number of questionnaires available for some scores.
CONCLUSION: The Transtar procedure was successful for long-term treatment of obstructed defecation syndrome. Fecal urgency and incontinence were observed, but typically resolved within months. Therefore, the Transtar procedure appears to be a reasonable approach to treating obstructed defecation syndrome in the long term.
Authors:
Susanne Bock; Katja Wolff; Lukas Marti; Bruno M Schmied; Franc H Hetzer
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Diseases of the colon and rectum     Volume:  56     ISSN:  1530-0358     ISO Abbreviation:  Dis. Colon Rectum     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-01-10     Completed Date:  2013-02-28     Revised Date:  2013-09-03    
Medline Journal Info:
Nlm Unique ID:  0372764     Medline TA:  Dis Colon Rectum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  246-52     Citation Subset:  IM    
Affiliation:
Department of Surgery, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Constipation / surgery*
Defecation
Digestive System Surgical Procedures / methods
Equipment Design
Fecal Incontinence / surgery*
Female
Health Status Indicators
Humans
Male
Middle Aged
Quality of Life
Rectum / surgery*
Retrospective Studies
Selection Bias
Surgical Staplers
Surgical Stapling / methods*
Syndrome
Treatment Outcome
Comments/Corrections
Comment In:
Dis Colon Rectum. 2013 Aug;56(8):e363   [PMID:  23838872 ]
Dis Colon Rectum. 2013 Aug;56(8):e363-4   [PMID:  23838873 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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