Original Scientific Paper

European Surgery

, Volume 45, Issue 1, pp 21-25

First online:

Clinical outcome after stapled transanal rectal resection for obstructed defecation syndrome: the first Iranian experience

  • R. AziziAffiliated withDepartment of Colorectal Surgery, Rasoul-e-Akram Hospital, Tehran University of Medical Sciences
  • , M. AlvandipourAffiliated withDepartment of Colorectal Surgery, Rasoul-e-Akram Hospital, Tehran University of Medical Sciences Email author 
  • , A. BijariAffiliated withDepartment of Colorectal Surgery, Rasoul-e-Akram Hospital, Tehran University of Medical Sciences
  • , S. ShoarAffiliated withDepartment of Colorectal Surgery, Rasoul-e-Akram Hospital, Tehran University of Medical SciencesDepartment of Surgery, Shariati Hospital, Tehran University of Medical Sciences
  • , M. AlemrajabiAffiliated withDepartment of Colorectal Surgery, Rasoul-e-Akram Hospital, Tehran University of Medical Sciences

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Summary

Background

Despite advances in treatment of obstructed defecation syndrome (ODS), no single therapy has been tolerated by all patients. Recently, stapled transanal rectal resection (STARR) has been shown to be a time-saving and relatively easy procedure for treatment of ODS with increasing acceptance by both the patient and surgeon. Our study indeed aimed to evaluate the efficacy and safety of STARR in patients with ODS due to anatomic abnormalities.

Methods

Fifty consecutive patients with ODS due to symptomatic rectal intussusceptions or rectocele were enrolled in this study. Preoperatively, all patients underwent rectosigmoidoscopy and defecography. All the patients with ODS score ³ 9 and rectal intussusceptions and/or rectocele with failure of at least 6 months medical treatment underwent STARR. Wexner incontinence score, ODS score, and Wexner score for severity of constipation were measured for each patient before and after the surgery.

Results

Mean ± standard deviation (SD) age of patients was 48.1 ± 1.1 years. Mean ± SD Longo score was 14.7 ± 0.9 before the procedure and 4.3 ± 0.7 after the procedure, which revealed statistically significant difference (p < 0.0001). The mean ± SD Wexner incontinence score was 0.6 ± 0.2 and 1.2 ± 0.3 before and after the STARR, respectively, which did not differ significantly (p = 0.1). However, Wexner constipation score revealed significant improvement after the surgery (13.9 ± 0.6 before the surgery vs. 3.4 ± 0.5 after the surgery; p < 0.0001).

Conclusions

STARR in patients with ODS due to rectocele or intussusceptions is associated with higher patient’s satisfaction and improvement in constipation, incontinency, and defecation score. STARR may be considered an alternative therapeutic option in ODSs with no desired response to other treatments.

Keywords

Obstructed defecation syndrome Stapled transanal rectal resection ODS score Wexner score STARR