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Clinical outcomes of stapled transanal rectal resection for obstructed defaecation syndrome at 10‐year follow‐up
Author(s) -
Schiano di Visconte M.,
Nicolì F.,
Pasquali A.,
Bellio G.
Publication year - 2018
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/codi.14028
Subject(s) - medicine , constipation , surgery , intussusception (medical disorder) , cohort , retrospective cohort study , resection
Aim The long‐term efficacy of stapled transanal rectal resection ( STARR ) for surgical management of obstructed defaecation syndrome ( ODS ) has not been evaluated. Therefore, we investigated the long‐term efficacy (> 10 years) of STARR for treatment of ODS related to rectocele or rectal intussusception and the factors that predict treatment outcome. Method This study was a retrospective cohort analysis conducted on prospectively collected data. Seventy‐four consecutive patients who underwent STARR for ODS between January 2005 and December 2006 in two Italian hospitals were included. Results Seventy‐four patients [66 women; median age 61 (29–77) years] underwent STARR for ODS . No serious postoperative complications were recorded. Ten years postoperatively, 60 (81%) patients completed the expected follow‐up. Twenty‐three patients (38%) reported persistent perineal pain and 13 (22%) experienced the urge to defaecate. ODS symptoms recurred in 24 (40%) patients after 10 years. At the 10‐year follow‐up, 35% of patients were very satisfied and 28% would recommend STARR and undergo the same procedure again if necessary. In contrast, 21% of patients would not select STARR again. Previous uro‐gynaecological or rectal surgery and high constipation scores were identified as risk factors for recurrence. Conclusions Stapled transanal rectal resection significantly improves the symptoms of ODS in the short term. In the long term STARR is less effective, however.