Stapled transanal rectal resection for obstructed defecation syndrome associated with rectocele and rectal intussusception

Abstract

To evaluate the safety and efficacy of stapled transanal rectal resection (STARR), and to analyze the outcome of the patients 12-mo after the operation. From May 2007 to October 2008, 50 female patients with rectocele and/or rectal intussusception underwent STARR. The preoperative status, perioperative and postoperative complications at baseline, 3, 6 and 12-mo were assessed. Data were collected prospectively from standardized questionnaires for the assessment of constipation [constipation scoring system, Longo's obstructed defecation syndrome (ODS) score system, symptom severity score], patient satisfaction (visual analogue scale), and quality of life (Patient Assessment of Constipation-Quality of Life Questionnaire). At a 12-mo follow-up, significant improvement in the constipation scoring system, ODS score system, symptom severity score, visual analog scale and quality of life (P < 0.0001) was observed. The symptoms of constipation improved in 90% of patients at 12 mo after surgery. The self-reported definitive outcome was excellent in 15 (30%) patients, fairly good in 8 (16%), good in 22 (44%), and poor in 5 (10%). STARR can be performed safely without major morbidity. Moreover, the procedure seems to be effective for patients with obstructed defecation associated with symptomatic rectocele and rectal intussusception.