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Clinical and Morphologic Correlation after Stapled Transanal Rectal Resection for Obstructed Defecation Syndrome

  • Original Contribution
  • Published:
Diseases of the Colon & Rectum

Abstract

Purpose

The clinical and morphologic outcome of patients with obstructed defecation syndrome after stapled transanal rectal resection was prospectively evaluated.

Methods

Twenty-four consecutive patients (22 women; median age, 61 (range, 36–74) years) who suffered from obstructed defecation syndrome and with rectal redundancy on magnetic resonance defecography were enrolled in the study. Constipation was assessed by using the Cleveland Constipation Score. Morphologic changes were determined by using closed-configuration magnetic resonance defecography before and after stapled transanal rectal resection.

Results

After a median follow-up of 18 (range, 6–36) months, Cleveland Constipation Score significantly decreased from 11 (range, 1–23) preoperatively to 5 (range, 1–15) postoperatively (P = 0.02). In 15 of 20 patients, preexisting intussusception was no longer visible in the magnetic resonance defecography. Anterior rectoceles were significantly reduced in depth, from 30 mm to 23 mm (P = 0.01), whereas the number of detectable rectoceles did not significantly change. Complications occurred in 6 of the 24 patients; however, only two were severe (1 bleeding and 1 persisting pain requiring reintervention).

Conclusions

Clinical improvement of obstructed defecation syndrome after stapled transanal rectal resection correlates well with morphologic correction of the rectal redundancy, whereas correction of intussusception seems to be of particular importance in patients with obstructed defecation syndrome.

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Authors and Affiliations

  1. Department of Surgery, Division of Visceral and Transplantation Surgery, University Hospital, Ramistrasse 100, CH-8091, Zurich, Switzerland

    Daniel Dindo M.D., Kuno Lehmann M.D., Pierre-Alain Clavien Ph.D. & Dieter Hahnloser M.D.

  2. Department of Radiology, University Hospital, Zurich, Switzerland

    Dominik Weishaupt M.D.

  3. Department of Surgery, Cantonal Hospital, St. Gallen, Switzerland

    Franc H. Hetzer M.D.

Authors
  1. Daniel Dindo M.D.
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  2. Dominik Weishaupt M.D.
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  3. Kuno Lehmann M.D.
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  4. Franc H. Hetzer M.D.
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  5. Pierre-Alain Clavien Ph.D.
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  6. Dieter Hahnloser M.D.
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Corresponding author

Correspondence to Dieter Hahnloser M.D..

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Dindo, D., Weishaupt, D., Lehmann, K. et al. Clinical and Morphologic Correlation after Stapled Transanal Rectal Resection for Obstructed Defecation Syndrome. Dis Colon Rectum 51, 1768–1774 (2008). https://doi.org/10.1007/s10350-008-9412-3

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  • DOI: https://doi.org/10.1007/s10350-008-9412-3

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