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STARR with Contour Transtar for Obstructed Defecation Syndrome: Long-Term Results

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Abstract

Introduction

Obstructed defecation syndrome (ODS) is a widespread and disabling syndrome. With this study, we want to evaluate the long-term results of stapled transanal rectal resection (STARR) performed with Contour Transtar device in the treatment for ODS. A re-evaluation of 113 patients subjected to STARR from June 2007 to January 2010 was conducted.

Methods

All the patients treated for symptomatic ODS with STARR with Contour Transtar were included in the study. We re-evaluate all patients treated in the study period with clinical examination and specific questionnaire to verify the stability of the functional results and the satisfaction at 5 years from surgery. Constipation was graded using the Agachan–Wexner constipation score; eventual use of aids to defecate and patient satisfaction were assessed preoperatively, 6 months and 5 years after surgery. Long-term complications were also investigated.

Results

Constipation intensity decreased from the preoperative value of 15.8 (±4.9) to 5.2 (±3.9) (p < 0.0001) at 6 months and remained stable after 5 years (7.4 ± 4.1; p < 0.01). Patients who use laxatives and enema decrease from 74 (77%) and 27 (28%) to only 16 (17%; p < 0.001) and 5 (5%; p < 0.001), respectively, at 5-year follow-up. None continue to help themselves with digitations after surgery. Also the satisfaction rate remained stable (3.64 vs 3.81) during the 5 years of the study.

Conclusion

The long-term results have demonstrated the efficacy of the STARR with Contour Transtar in treating ODS and the stability over time of the defecatory improvements.

Clinical trial registration

Clinicaltrials.gov NCT02971332.

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Acknowledgement

The study was reviewed and approved by the St. Andrea Hospital Institutional Review Board.

Authors contribution

Francesco Saverio Mari gave substantial contributions to conception, design, analysis and interpretation of data and drafting and final approval the article. Massimo Pezzatini gave substantial contributions to analysis and interpretation of data, drafting and final approval the article. Marcello Gasparrini gave substantial contributions to analysis and interpretation of data, drafting and final approval the article. Antonio Brescia gave substantial contributions to conception the study and interpretation of data and revising the article critically and final approval of the version to be published.

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Authors and Affiliations

  1. UO Week Day Surgery, St. Andrea Hospital, Via di Grottarossa 1035, 00189, Rome, Italy

    Francesco Saverio Mari, Massimo Pezzatini, Marcello Gasparrini & Brescia Antonio

  2. Department of Medical and Surgical Sciences and Translational Medicine, University Sapienza of Rome, Rome, Italy

    Francesco Saverio Mari, Massimo Pezzatini, Marcello Gasparrini & Brescia Antonio

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  1. Francesco Saverio Mari
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Correspondence to Francesco Saverio Mari.

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Mari, F.S., Pezzatini, M., Gasparrini, M. et al. STARR with Contour Transtar for Obstructed Defecation Syndrome: Long-Term Results. World J Surg 41, 2906–2911 (2017). https://doi.org/10.1007/s00268-017-4084-6

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  • DOI: https://doi.org/10.1007/s00268-017-4084-6

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