Midterm outcome of stapled transanal rectal resection for obstructed defecation syndrome:A single-institution experience in China

作     者：Bin Zhang Jian-Hua Ding Yu-Juan Zhao Meng Zhang Shu-Hui Yin Ying-Ying Feng Ke Zhao 

作者机构：Department of Colorectal Surgerythe Second Artillery General Hospital Department of Laboratory Medicinethe Second Artillery General Hospital 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2013年第19卷第38期

页      面：6472-6478页

核心收录：

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

基　　金：Supported by Clinical Research Fund of Beijing Municipal Science and Technology Commission No.Z111107058811051 

主　　题：Colorectal surgery Constipation Stapled transanal rectal resection 

摘      要：AIM:To assess midterm results of stapled transanal rectal resection(STARR)for obstructed defecation syndrome(ODS)and predictive factors for ***:From May 2007 to May 2009,75 female patients underwent STARR and were included in the present *** and postoperative workup consisted of standardized interview and physical examination including proctoscopy,colonoscopy,anorectal manometry,and *** and functional results were assessed by standardized questionnaires for the assessment of constipation constipation scoring system(CSS),Longo’s ODS score,and symptom severity score(SSS),incontinence Wexner incontinence score(WS),quality of life Patient Assessment of Constipation-Quality of Life Questionnaire(PAC-QOL),and patient satisfaction visual analog scale(VAS).Data were collected prospectively at baseline,12 and 30 ***:The median follow-up was 30 mo(range,30-46 mo).Late postoperative complications occurred in 11(14.7%)*** of these patients required procedure-related reintervention(one diverticulectomy and two excision of staple granuloma).Although the recurrence rate was 10.7%,constipation scores(CSS,ODS score and SSS)significantly improved after STARR(P0.0001).Significant reduction in ODS symptoms was matched by an improvement in the PAC-QOL and VAS(P0.0001),and the satisfaction index was excellent in 25(33.3%)patients,good in 23(30.7%),fairly good in 14(18.7%),and poor in 13(17.3%).Nevertheless,the WS increased after STARR(P=0.0169).Incontinence was present or deteriorated in 8(10.7%)patients;6(8%)of whom were new *** analysis revealed that the occurrence of fecal incontinence(preoperative,postoperative or new-onset incontinence;P=0.028,0.000,and 0.007,respectively)was associated with the success of the ***:STARR is an acceptable procedure for the surgical correction of ***,its impact on symptomatic recurrence and postoperative incontinence may be problematic.