Solitary rectal ulcer syndrome: clinical findings, surgical treatment, and outcomes

Torres, Carlos; Khaikin, Marat; Bracho, Jorge A. Soto; Luo, Cheng Hua; Weiss, Eric G.; Sands, Dana R.; Cera, Susan; Nogueras, Juan J.; Wexner, Steven D.

doi:10.1007/s00384-007-0344-5

Cited by 43 publications

(27 citation statements)

References 20 publications

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“…History of chronic constipation was 20% and 28% in these studies respectively. [15][16][17] The diagnosis and management of SRUS is difficult despite of modern medical techniques because of its varied clinical presentation. Drug treatment, such as sulfasalazine, local or systemic corticosteroid and antibiotics have not shown obvious improvement.…”

Section: Discussionmentioning

confidence: 99%

STARR surgery in treatment of SRUS: an observational study on clinical outcomes

Porwal¹,

Gandhi²,

Kulkarni³

2018

Int Surg J

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Background: SRUS is a condition with inadequately learned pathogenesis and usually associated with disorders of pelvic floor. Commonly seen in young adults and impairs quality of life. Because of these facts the management of SRUS is difficult and there is no clear consensus over it.Methods: An observational, prospective study was planned at a single center with purposive sampling. All clinically diagnosed, histologically and endoscopically confirmed SRUS patients treated with STARR surgery and followed for two years. Data collected and analyzed to evaluate the effectiveness and patients satisfaction.Results: Total of 46 patients with median age 47.8 years; of which 27 (58.70%) were females underwent STARR surgery. The average procedure time was 40 minutes, average length of stay was 24 hours and minimum duration of follow up was about 2 years (range 2-4 years). All patients had a pre-surgery history of digitations, which resolved in 91.3% patients post-surgery. There was a significant improvement in the ODS scores at the end of 2 years (82%; P <0.001). Excessive bleeding from staple line (48.57%), staple line dehiscence in 34.28% and staple line stricture (15.71% all males) are complications observed. No recurrence reported at the end of 4 years.Conclusions: Short postoperative length of stay and the short time to return to work after the STARR procedure for management SRUS, minimal manageable complications, no recurrence and patient’s satisfaction makes STARR a cost-effective procedure.

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Section: Discussionmentioning

confidence: 99%

STARR surgery in treatment of SRUS: an observational study on clinical outcomes

Porwal¹,

Gandhi²,

Kulkarni³

2018

Int Surg J

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“…Patient noticed the first symptoms at the age of 56 years, which is later than the most common cases of SRUS in women (usually between 40 and 50 years; however, there is a wide age-range for the disease: 12–77 years) [1–4]. The SRUS aetiology, despite many studies and observations, has not been discovered.…”

Section: Discussionmentioning

confidence: 99%

“…The disorders usually include the presence of mucus, fresh blood, and/or mucous-purulent matter. Additionally, defecation disorders are common, including problems with initiation of defecation, painful, long-lasting rectal tenestmus, a feeling of incomplete defecation, and constipation [1, 4, 7, 8]. It is often connected with frequent visits to the toilet and initiating defecation using a finger.…”

Section: Discussionmentioning

confidence: 99%

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Effective treatment of solitary rectal ulcer syndrome using argon plasma coagulation

Waniczek¹,

Rdes²,

Rudzki³

et al. 2014

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Solitary rectal ulcer syndrome (SRUS) is a chronic, multiform, non-cancerous disorder of the rectum, the final diagnosis of which is based upon histopathological criteria. This disorder is often accompanied by latent proctoptosis. We present a patient who (in 1996) was the first case in which argon plasma coagulation (APC) was used for SRUS treatment. In the years 2004–2005 the same patient underwent 15 APC sessions (at monthly intervals) obtaining full recovery from SRUS, although she had been treated unsuccessfully for 17 years prior to that. Six-year observation did not show any relapse. Local therapy with APC seems to be an important alternative in SRUS treatment without prolapse of the rectum and could become a basic method for bleeding treatment in SRUS.

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“…Rektopexie, Resektionsrektopexie, anteriore Sigma-/Rektumresektion) und transanale Verfahren (z.B. Delorme, Altemeier) mit unterschiedlichen Erfolgsraten angewandt wurden, wobei eine funktionelle Verbesserung der Symptome nur bei 60-70% der Patienten erreicht werden konnte [13][14][15][16][17]. Generell ist eine Vergleichbarkeit der in den publizierten Studien dargestellten Ergebnisse jedoch infolge der Heterogenität der Patientenkollektive und der Befunde -der Begriff "Rektumulkus" reicht vom einfachen mechanisch-induzierten Ulkus bis hin zu langstreckigen Rektumstenosen, induziert durch langjährige, therapierefraktäre Rektumulzera -nicht gegeben.…”

Section: Ergebnisseunclassified

Das solitäre Rektumulkus – wirklich eine Entität?*

Schwandner

Dietl²,

Stadler³

et al. 2008

Coloproctol

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ZusammenfassungZiel: Ziel dieser Studie war es, die Prävalenz und klinischen Ausprägungen beim solitären Rektumulkus zu analysieren, um so Schlussfolgerungen für Diagnostik, Therapie und Terminologie ableiten zu können. Patienten und Methodik: Es erfolgte eine retrospektive Auswertung derjenigen Patienten, die zwischen Januar 2007 und November 2007 an der eigenen Klinik wegen eines solitären Rektumulkus behandelt wurden. Analysiert wurden Alter, Geschlecht, Symptome, assoziierte Befunde, Therapie und Histologie. Ergebnisse: Innerhalb des Beobachtungszeitraums wurden 1 124 Patienten in der Proktologischen Sprechstunde vorgestellt. Aus dieser Gruppe konnten acht Patienten identifiziert werden, die wegen eines solitären Rektumulkus behandelt wurden (0,7%). Häufigste Symptome waren Entleerungsstörung, Blutung und intraanale Schmerzen. Bei drei Patientinnen war das Rektumulkus mit einem inneren Rektumprolaps assoziiert, bei einem männlichen Patienten ergab die Biopsie ein muzinöses Adenokarzinom des Rektums. Die Mehrzahl der Patienten wurde operativ behandelt.Schlussfolgerung: Die retrospektive Analyse eines proktologischen Krankenguts zeigt, dass die Prävalenz eines "solitären Rektumulkus" mit 0,7% sehr selten ist. Schlussfolgern lässt sich, dass 1. der Malignomausschluss eine Conditio sine qua non ist, 2. häufig eine Entleerungsstörung mit Rektumprolaps vorliegt und 3. der Begriff "solitäres Rektumulkus" noch viele Unklarheiten in sich birgt. Schlüsselwörter: Solitäres Rektumulkus · Rektumprolaps · EntleerungsstörungSolitary Rectal Ulcer Syndrome -Is It Really One Entity? Abstract Purpose: It was the aim of this study to analyze prevalence and clinical appearance of "solitary rectal ulcer syndrome" to identify the impact on diagnostic assessment, therapy, and terminology. coloproctology 2008;30:165-9

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Solitary rectal ulcer syndrome: clinical findings, surgical treatment, and outcomes

Cited by 43 publications

References 20 publications

STARR surgery in treatment of SRUS: an observational study on clinical outcomes

STARR surgery in treatment of SRUS: an observational study on clinical outcomes

Effective treatment of solitary rectal ulcer syndrome using argon plasma coagulation

Das solitäre Rektumulkus – wirklich eine Entität?*

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