Surgery for obstructed defaecation: does the use of the Contour device (Trans‐STARR) improve results?

Wadhawan, Himanshu; Shorthouse, A. J.; Brown, S. R.

doi:10.1111/j.1463-1318.2009.01876.x

Cited by 27 publications

(12 citation statements)

References 14 publications

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“…However, there were also some opposing views. Wadhawan et al[ 97 ] and Naldini et al[ 65 ] indicated that there were no statistically significant differences in postoperative clinical outcome, early complications, postoperative pain or hospital stay between PPH-STARR procedure and Contour-Transtar procedure. Similarly, Boccasanta et al[ 98 ] demonstrated that no improvements in symptoms and defecographic parameters were observed postoperatively in patients who underwent operation using Contour-Transtar procedure compared with PPH-STARR procedure.…”

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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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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“…The optimal treatment of patients with combined STC and ODS is still unclear. Solely stapled transanal rectal resection (STARR) or colectomy with ileorectal anastomosis could not resolve the coexisting problems [ 1 , 7 ]. Inspired by the modified Duhamel operation, in this study we introduced a new surgical procedure, named the Jinling procedure after our hospital, to treat mixed constipation ( Figure 1 ).…”

Section: Introductionmentioning

confidence: 99%

Novel surgery for refractory mixed constipation: Jinling procedure – technical notes and early outcome

Ding¹,

Jiang²,

Feng³

et al. 2014

aoms

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IntroductionThe treatment of slow-transit constipation combined with outlet obstruction is controversial. This study introduced a new surgical strategy, subtotal colectomy combined with a modified Duhamel procedure (Jinling procedure), of which the safety and satisfactory rate were examined.Material and methodsNinety patients with refractory slow-transit constipation associated with outlet obstruction were consecutively included between Jan 2010 and Dec 2010. All underwent the laparoscopic-assisted Jinling procedure, which added a new side-to-side anastomosis to the colorectal posterior anastomosis after subtotal colectomy. The pre- and post-operative data were collected.ResultsThere was no surgery-related death. A total of 39 complications and adverse events were reported in 22 patients (morbidity rate of 24.4%). Most complications were managed conservatively without significant events. The satisfactory rate was 93.1% at 6-month follow-up.ConclusionsThe Jinling procedure is safe for refractory slow-transit constipation associated with outlet obstruction, with minimal major complications and a high satisfaction rate. However, this procedure requires rigorous preoperative examination, exquisite surgical and laparoscopic techniques and excellent perioperative management. The pelvic floor, especially the presacral space, is damaged, and therefore it may be unsalvageable if severe complications, such as anastomosis leakage or ischemia, occur.

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“…4 However, several reports have raised doubts about the long-term success of STARR for the treatment of obstructive defecation. [6][7][8][9] In one study, Dodi et al 9 reported severe postoperative complications, including rectal bleeding, anal pain, fecal incontinence, and rectovaginal fistula, or recurrence of rectocele, rectal intussusception, or obstructed defecation symptoms, in 14 patients who underwent the STARR procedure.…”

mentioning

confidence: 98%

“…Several studies have shown that the sole use of STARR or colectomy with ileorectal anastomosis does not resolve the coexisting problems. 2,6,7 Some authors have recommended preoperative biofeedback to improve functional results after subtotal colectomy in patients with slow-transit constipation and obstructive defecation. 14 However, in a study evaluating preoperative biofeedback and subtotal colectomy in 16 patients with combined slowtransit constipation and nonrelaxing pelvic floor, Bernini et al 21 found that 37.5% of patients still complained of incomplete evacuation.…”

mentioning

confidence: 99%

Long-term Follow-up of the Jinling Procedure for Combined Slow-Transit Constipation and Obstructive Defecation

Jiang

Feng

et al. 2013

Diseases of the Colon &Amp; Rectum

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Surgery for obstructed defaecation: does the use of the Contour device (Trans‐STARR) improve results?

Cited by 27 publications

References 14 publications

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

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

Novel surgery for refractory mixed constipation: Jinling procedure – technical notes and early outcome

Long-term Follow-up of the Jinling Procedure for Combined Slow-Transit Constipation and Obstructive Defecation

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