Randomized controlled study to compare the outcome after stapled transanal rectal resection and that after transanal Delorme's for surgical treatment of obstructed defecation

Abstract

Context Obstructed defecation syndrome (ODS) is characterized mainly by difficulty in defecation that greatly affects the quality of life. Several surgical methods and techniques have been designed to correct the anatomical deformities associated with ODS. Aims The study was designed to assess the safety and efficiency of stapled transanal rectal resection (STARR) and compare it with modified Delorme's procedure in the treatment of ODS. Settings and design This was a randomized controlled trial registered under PACTR201403000477391. Patients and methods Sixty patients with obstructed defecation (OD) associated with rectocele and/or rectal intussusception were randomly allocated to two groups: group I was subjected to modified Delorme's procedure (30 patients) and group II was subjected to STARR (30 patients). Statistical analysis used Results were expressed as mean ± SD. The difference between pretreatment and post-treatment data was analyzed by means of a t-test. The level of significance was 0.05. Results The pretreatment OD score showed no significant difference between the two groups. The OD score showed that there was no significant difference between the two groups up to 3 months’ follow-up. However, from 6 months up to 2 years the score became significantly better after modified Delorme's operation than after STARR. No mortality or major complications occurred during this study. Conclusion In the present study, both STARR and modified Delorme's procedure seemed to be a safe and effective treatment method for ODS, but after 1 year the improvement in symptoms became significantly better after modified Delorme's procedure than after STARR.