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01-09-2010 | Original Article

Quo Vadis STARR? A Prospective Long-Term Follow-Up of Stapled Transanal Rectal Resection for Obstructed Defecation Syndrome

Authors: Oliver Zehler, Yogesh K. Vashist, Dean Bogoevski, Maximillian Bockhorn, Emre F. Yekebas, Jakob R. Izbicki, Asad Kutup

Published in: Journal of Gastrointestinal Surgery | Issue 9/2010

Abstract

Introduction

Functional and clinical long-term outcome after stapled transanal rectal resection (STARR) in patients with an isolated symptomatic rectocele are investigated. Short-term results after 1 year are comparable with the functional outcome even after 5 years. Eighty per cent of the patients were still satisfied. STARR is an alternative procedure to the conventional surgical approaches for patients with an obstructed defecation syndrome and rectocele. Several studies have reported short-term outcome after STARR, but long-term results are still missing. The objective of this study was to evaluate long-term clinical outcome after STARR with a follow-up of 5 years.

Materials and Methods

Twenty patients with only an isolated symptomatic rectocele due to obstructed defecation syndrome were subjected to STARR. Functional and clinical outcome was assessed by Outlet Obstruction Syndrome score (OOS score), Wexner score (WS), and Symptome Severity score (SSS score). Data were prospectively collected over 7 years.

Results

The perioperative morbidity after STARR accounted for 20% (n = 4). One patient was subjected to reoperation due to perforation, two postoperative bleedings occurred, and one patient developed an increasing local granulomatous reaction at the stapler line. The median follow-up accounted for 66 months (range 60–84). Sixteen patients (80%) were satisfied with the functional outcome. The median OOS, SSS and WS score improved significantly already after 1 year in these patients and remained stable at 5-year follow-up. In contrast, four patients were classified as treatment failures since the OOS score and the SSS score showed no improvement. At 5-year follow-up, these patients remained symptomatic without improvement in OOS and SSS scores.

Conclusions

The STARR procedure is an effective operation in isolated symptomatic rectoceles with regard to relief of the obstructed defecation syndrome. The short-term improvement after STARR predicts long-term outcome in obstructed defecation syndrome caused by a rectocele.

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Title: Quo Vadis STARR? A Prospective Long-Term Follow-Up of Stapled Transanal Rectal Resection for Obstructed Defecation Syndrome
Authors: Oliver Zehler
Yogesh K. Vashist
Dean Bogoevski
Maximillian Bockhorn
Emre F. Yekebas
Jakob R. Izbicki
Asad Kutup
Publication date: 01-09-2010
Publisher: Springer-Verlag
Published in: Journal of Gastrointestinal Surgery / Issue 9/2010
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-010-1261-4

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Quo Vadis STARR? A Prospective Long-Term Follow-Up of Stapled Transanal Rectal Resection for Obstructed Defecation Syndrome

Abstract

Introduction

Materials and Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Materials and Methods

Results

Conclusions

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