| Stapled transanal rectal resection for outlet obstruction syndrome: results and follow-up. | |
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MedLine Citation:
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PMID: 18350243 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Journal Article |
Journal Detail:
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Title: World journal of surgery Volume: 32 ISSN: 0364-2313 ISO Abbreviation: World J Surg Publication Date: 2008 Jun |
Date Detail:
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Created Date: 2008-05-19 Completed Date: 2008-10-01 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7704052 Medline TA: World J Surg Country: United States |
Other Details:
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Languages: eng Pagination: 1110-5 Citation Subset: IM |
Affiliation:
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Department of Surgery, University of Genoa, Di.C.M.I., Largo Rosanna Benzi 8, Genoa 16132, Italy. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Anal Canal
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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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