Document Detail


Stapled transanal rectal resection for outlet obstruction syndrome: results and follow-up.
MedLine Citation:
PMID:  18350243     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The objective of the present study was to assess safety, effectiveness, and long-term outcomes of stapled transanal rectal resection (STARR) for the cure of outlet obstruction syndrome (OOS). METHODS: Data were collected over a 3-year period (2004-2007), at the Department of Surgery of the University of Genoa, from 25 consecutive subjects (19 of them females) undergoing STARR because of OOS that had not responded to medical treatment,. RESULTS: Preoperatively, patients were submitted to clinical examination, defecography, colonoscopy, manometry, and recto-anal reflexes determination. All patients had mucosal prolapse, 15 rectal intussusception, 15 rectocele. Postoperatively no deaths were observed; one patient had a hemorrhage requiring reintervention. Mean time to resumption of normal activity was 8.5 +/- 4.5 days. Patients were followed for a mean of 24.7 +/- 10.9 months (range: 6-42 months). Late specific complications included 3 cases of urge to defecate, 8 of incontinence to flatus. Functional outcome was positive for 22 patients (excellent in 4 cases, good in 15, fairly good in 3). Six months postoperatively (25 s), patients had improvement of the mean Constipation Score (p = 0.0002), less pain during evacuation (p = 0.0003), and reduced use of digital assistance to defecate (p < 0.0001). Continence Grading Scale and enema use remained stable after intervention. Patients had increase in basal sphincter pressure (p = 0.0078) and maximal squeeze pressure (p = 0.0051). Recto-anal reflex study showed increase in abdominal pain threshold (p < 0.0001); anal sphincter relaxation threshold and desire to defecate threshold did not change. CONCLUSIONS: According to the present study, STARR seemed to be a safe and effective treatment for OOS associated with symptomatic rectocele and intussusception.
Authors:
Marco Frascio; Cesare Stabilini; Barbara Ricci; Paolo Marino; Rosario Fornaro; Luigi De Salvo; Francesca Mandolfino; Fabrizio Lazzara; Ezio Gianetta
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  World journal of surgery     Volume:  32     ISSN:  0364-2313     ISO Abbreviation:  World J Surg     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-05-19     Completed Date:  2008-10-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7704052     Medline TA:  World J Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1110-5     Citation Subset:  IM    
Affiliation:
Department of Surgery, University of Genoa, Di.C.M.I., Largo Rosanna Benzi 8, Genoa 16132, Italy.
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MeSH Terms
Descriptor/Qualifier:
Anal Canal / surgery
Female
Follow-Up Studies
Humans
Intestinal Obstruction / etiology,  surgery*
Intussusception / complications,  surgery
Male
Rectal Diseases / complications,  surgery*
Rectal Prolapse / surgery
Rectocele / complications,  surgery
Rectum / surgery*
Surgical Stapling
Treatment Outcome

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


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