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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Disappointing long-term outcomes after stapled transanal rectal resection for obstructed defecation
World Journal of Surgery, Volume 34, No. 9, Year 2010
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Description
Background: The aim of this study was to assess both short and long-term functional outcomes and the quality of life of patients treated with stapled transanal rectal resection (STARR) for obstructed defecation syndrome (ODS). Methods: Forty-six patients with ODS as a result of rectocele and/or rectal intussusceptions were treated with STARR. Data collected included demographics, OR time, pain score using a visual analog scale (VAS), and complications. The study included defecographic assessment and anal manometry [urge-to-defecate volume (UTDV) and maximum tolerable volume (MTV)], both done preoperatively and 1 year postoperatively. A modified obstructed-defecation syndrome questionnaire (MODS), constipation quality of life (PAC-QOL) score, and CCF continence score were all recorded preoperatively and every 6 months during follow-up. Results: Mean age of the patients was 48.4 years. Fortyfive patients had mild postoperative pain (VAS = 1-2). Only one male patient had severe pain (VAS = 7). Three patients developed stenosis at the staple line 6 months after surgery and were dilated manually. Follow-up ranged from 18 to 48 months and the median follow-up was 42 months. The recurrence rate was 6.5% after 18 months, 10.8% after 36 months, and 13% after 42 months. Significant reduction in MTV and UTDV was recorded. MODS and PACQOL showed significant improvement after 6 months; this improvement was maintained for 18 months and then there was a rapid decline until the end of the follow-up period. Conclusions: STARR is a safe surgical procedure that effectively restores the anatomy and function of the anorectum in patients with ODS. This correction improves functional and QOL scores; however, a high rate of symptomatic recurrence and QOL score decline are expected after 18 months. © Société Internationale de Chirurgie 2010.
Authors & Co-Authors
Madboulay, Khaled
Egypt, Alexandria
Faculty of Medicine
Abbas, Khaled S.
Egypt, Alexandria
Faculty of Medicine
Hussein, Ahmed M.
Egypt, Alexandria
Faculty of Medicine
Statistics
Citations: 74
Authors: 3
Affiliations: 1
Identifiers
Doi:
10.1007/s00268-010-0638-6
ISSN:
03642313
e-ISSN:
14322323
Research Areas
Disability
Health System And Policy
Study Design
Cohort Study
Participants Gender
Male