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Stapled transanal rectal resection (STARR) for rectocele.

¹Department of Surgery, University of South Alabama, Mobile, AL, USA. nellis@usouthal.edu

Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract

|March 29, 2007

Summary

Stapled transanal rectal resection (STARR) effectively treats obstructed defecation by improving rectal function and reducing symptoms. This procedure offers significant symptom relief with a low risk of complications for patients.

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Area of Science:

Gastroenterology
Colorectal Surgery
Pelvic Floor Disorders

Background:

Obstructed defecation is characterized by difficulty initiating rectal emptying, incomplete evacuation, and straining.
Pathophysiological features include increased rectal diameter, reduced compliance, and elevated sensory threshold.
Transanal rectal resection techniques have emerged for treating this condition.

Purpose of the Study:

To evaluate the efficacy and safety of Stapled Transanal Rectal Resection (STARR) for obstructed defecation.

Main Methods:

The study analyzed outcomes from a large series of patients undergoing the STARR procedure.
Measurements included changes in rectal diameter, compliance, and sensory threshold.
Patient-reported outcomes such as evacuation, straining, pain, and laxative use were assessed.

Main Results:

STARR decreased rectal diameter, restored compliance, and lowered the sensory threshold.
Significant improvements were observed in incomplete evacuation (81.1%), need for digital assistance (83.4%), pelvic pain (43.3%), and laxative use (43.3%).
Procedure-related risks included stenosis (3.3%), urgency (1.1%), and flatus incontinence (1.1%).

Conclusions:

The STARR procedure is an effective treatment for obstructed defecation.
It demonstrates a favorable risk-benefit profile with acceptable complication rates.