Stapled transanal rectal resection (<scp>STARR</scp>) for obstructive defaecation syndrome: patients with previous pelvic floor surgery have poorer long‐term outcome

Adams, Katie; Papagrigoriadis, Savvas

doi:10.1111/codi.12054

Cited by 5 publications

(2 citation statements)

References 13 publications

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“…Incidences of serious complications were reported but these were rare. These included: one case of sepsis with retropneumoperitoneum , two cases of intra‐operatively recognized rectal perforation requiring diverting colostomy , one case of rectovaginal abscess requiring diversion , one case of suture line disruption requiring diversion , and one case of rectal necrosis requiring a colostomy . There were no cases of inadvertent small bowel injury as a result of peritoneal inclusion with anterior rectal wall excision and enterocoele excision.…”

Section: Harmsmentioning

confidence: 99%

Surgery for constipation: systematic review and practice recommendations

et al. 2017

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Aim To assess the outcomes of rectal excisional procedures in adults with chronic constipation.Method Standardised methods and reporting of benefits and harms were used for all CapaCiTY reviews that closely adhered to PRISMA 2016 guidance. Main conclusions were presented as summary evidence statements with a summative Oxford Centre for Evidence-Based Medicine (2009) level.Results Forty-seven studies were identified, providing data on outcomes in 8340 patients. Average length of procedures was 44 min and length of stay (LOS) was 3 days. There was inadequate evidence to determine variations in procedural duration or LOS by type of procedure. Overall morbidity rate was 16.9% (0-61%), with lower rates observed after Contour Transtar procedure (8.9%). No mortality was reported after any procedures in a total of 5896 patients. Although inconsistently reported, good or satisfactory outcome occurred in 73-80% of patients; a reduction of 53-91% in Longo scoring system for obstructive defecation syndrome (ODS) occurred in about 68-76% of patients. The most common long-term adverse outcome is faecal urgency, typically occurring in up to 10% of patients. Recurrent prolapse occurred in 4.3% of patients. Patients with at least 3 ODS symptoms together with a rectocoele with or without an intussusception, who have failed conservative management, may benefit from a rectal excisional procedure.Conclusion Rectal excisional procedures are safe with little major morbidity. It is not possible to advise which excisional technique is superior from the point of view of efficacy, peri-operative variables, or harms. Future study is required.

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Section: Harmsmentioning

confidence: 99%

Surgery for constipation: systematic review and practice recommendations

et al. 2017

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“…It requires extensive experience to avoid further postoperative complications and to carefully resect the rectocele and prolapsed tissue. Besides, it may not be suitable for patients with previous pelvic floor surgery[ 66 ]. And there were some controversial points of view regarding the complication and poor postoperative outcome of this procedure[ 67 , 68 ].…”

Section: Alternative Transanal Surgical Procedures For Odsmentioning

confidence: 99%

Transanal surgery for obstructed defecation syndrome: Literature review and a single-center experience

Liu

Wan

Yaseen

et al. 2016

WJG

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Obstructed defecation syndrome (ODS) is a functional disorder commonly encountered by colorectal surgeons and gastroenterologists, and greatly affects the quality of life of patients from both societal and psychological aspects. The underlying anatomical and pathophysiological changes of ODS are complex. However, intra-rectal intussusception and rectocele are frequently found in patients with ODS and both are thought to play an important role in the pathogenesis of ODS. With the development of evaluation methods in anorectal physiology laboratories and radiology studies, a great variety of new operative procedures, especially transanal procedures, have been invented to treat ODS. However, no procedure has been proved to be superior to others at present. Each operation has its own merits and defects. Thus, choosing appropriate transanal surgical procedures for the treatment of ODS remains a challenge for all surgeons. This review provides an introduction of the current problems and options for treatment of ODS and a detailed summary of the essential assessments needed for patient evaluation before carrying out transanal surgery. Besides, an overview of the benefits and problems of current transanal surgical procedures for treatment of ODS is summarized in this review. A report of clinical experience of some transanal surgical techniques used in the authors’ center is also presented.

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Il pavimento pelvico non esiste – transanale Verfahren in der Behandlung des obstruktiven Defäkationssyndroms und Descensus perinei

Aumann

Longo²

2021

coloproctology

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Stapled transanal rectal resection (STARR) for obstructive defaecation syndrome: patients with previous pelvic floor surgery have poorer long‐term outcome

Abstract: Residual symptoms are a strong indicator of long-term failure. STARR was effective for symptom resolution in 50% of patients. Those who had undergone pelvic floor or rectal prolapse surgery were significantly more likely to experience recurrent symptoms.

Cited by 5 publications

References 13 publications

Surgery for constipation: systematic review and practice recommendations

Surgery for constipation: systematic review and practice recommendations

Transanal surgery for obstructed defecation syndrome: Literature review and a single-center experience

Il pavimento pelvico non esiste – transanale Verfahren in der Behandlung des obstruktiven Defäkationssyndroms und Descensus perinei

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