Functional outcome and quality of life after stapled transanal rectal resection for obstructed defecation syndrome.
نویسندگان
چکیده
PURPOSE Clinical studies have demonstrated that stapled transanal rectal resection with Contour Transtar (Transtar procedure) is a safe and effective treatment for patients with obstructive defecation syndrome. The aim of this study was to determine functional outcome and quality of life after the procedure. METHODS Female patients with obstructive defecation syndrome were enrolled prospectively for the Transtar procedure. Intussusception and anterior rectocele were confirmed by clinical investigation and by magnetic resonance defecography. Functional outcome was measured by obstructed defecation syndrome score, severity of symptoms score, and Wexner score preoperatively and postoperatively. Quality of life was assessed by the Cleveland Clinic constipation score, the fecal incontinence quality of life scale, and the SF-36v2 health survey. RESULTS Between January 2007 and November 2008, 52 consecutive patients (median age: 64 years) were included in the study. Before the surgery, 12 patients experienced fecal incontinence. Functional scores improved significantly: 6 weeks after surgery, the obstructed defecation syndrome score decreased from a median of 16 (range, 9-22) to 5 (range, 2-10) and the severity of symptoms score, from 16 (range, 9-21) to 4 (range, 0-9) (each P < .0001). After 6 weeks, 10 patients had fecal incontinence and 12 patients experienced fecal urgency. At 3 months, 6 patients were still incontinent, 3 of whom were treated successfully with sacral neuromodulation. Fecal urgency resolved in all cases after 6 months. Quality of life improved, particularly in the mental components. CONCLUSION Despite the described postoperative symptoms, most of which can be treated conservatively, the Transtar procedure is an effective treatment for patients with obstructive defecation syndrome and improves quality of life significantly.
منابع مشابه
The impact of stapled transanal rectal resection on anorectal function in patients with obstructed defecation syndrome.
PURPOSE A careful preoperative selection of patients was performed in order to identify those eligible for stapled transanal rectal resection to correct obstructed defecation syndrome. The aim was to assess the consequences of surgery on anorectal function and patient outcomes. METHODS From January 2004 to June 2007, 33 female patients (median age, 56.3 years; range, 27-77 years) eligible for...
متن کاملStapled transanal rectal resection for obstructed defecation syndrome: one-year results of the European STARR Registry.
PURPOSE Stapled transanal rectal resection is advocated for the treatment of obstructed defecation syndrome. Supporting evidence for its safety and effectiveness has been lacking. To address this, the European Stapled Transanal Rectal Resection Registry was initiated in January 2006. This study was designed to analyze 12-month postoperative outcomes of this procedure using data collected in the...
متن کاملStapled Trans-Anal Rectal Resection (STARR) for Obstructive Defecation Syndrome—Functional Outcome and Quality of Life after Two Years
Background: Stapled transanal rectal resection (STARR) has been shown to improve patients’ functional and quality of life outcomes in several studies. Although it is a safe and effective treatment for obstructive defecation syndrome, still data on long-term follow-up are missing. Methods: From January 2010 to July 2014, 46 consecutive patients undergoing STARR using the CONTOUR® TRANSTARTM devi...
متن کاملComparing the Outcomes of Stapled Transanal Rectal Resection, Delorme Operation and Electrotherapy Methods Used for the Treatment of Obstructive Defecation Syndrome
Background: Pathophysiology and treatment of obstructive defecation syndrome (ODS) remains to be defined clearly. Rectal hidden intussusceptions and voluminous hemorrhoids may be the cause. Where conservative treatment is not effective, ODS can be treated by STARR or Delorme operation. In some patients treatment of advance hemorrhoidal disease may resolve the syndrome. Methods: 81 females out o...
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ورودعنوان ژورنال:
- Diseases of the colon and rectum
دوره 53 6 شماره
صفحات -
تاریخ انتشار 2010