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Stapled transanal rectal resection for symptomatic intussusception: morphological and functional outcome.
Reinhold A Lang1, Sonja Buhmann, Christine Lautenschlager
1Department of Surgery, Klinikum Grosshadern, University of Munich, Marchioninistrasse 15, 81377 Munich, Germany. Reinhold.Lang@med.uni-muenchen.de
Surgical Endoscopy
|February 6, 2010
Summary
Stapled transanal rectal resection (STARR) improved rectal morphology in patients with obstructed defecation. However, functional outcomes like incomplete defecation symptoms persisted in some patients post-STARR surgery.
Area of Science:
- Colorectal Surgery
- Gastroenterology
- Pelvic Floor Disorders
Background:
- Stapled transanal rectal resection (STARR) is a surgical technique to address obstructed defecation caused by intussusception.
- Some patients do not achieve satisfactory outcomes after STARR surgery.
- Understanding the link between rectal morphology changes and functional results post-STARR is crucial.
Purpose of the Study:
- To investigate the relationship between functional outcomes and rectal morphology following STARR surgery.
- To evaluate the effectiveness of STARR in correcting intussusception and its impact on obstructed defecation symptoms.
Main Methods:
- A study involving 15 female patients with obstructed defecation undergoing STARR.
- Pre- and postoperative assessments included clinical interviews (Wexner score), physical examinations, anorectal manometry, and MR defecography.
- Median follow-up was 18 months.
Main Results:
- STARR was technically successful with no complications.
- Significant reduction in intussusception and rectocele size was observed post-surgery.
- While fecal incontinence scores slightly increased, incomplete defecation symptoms persisted in 7/15 patients.
- Rectal sensation threshold decreased post-STARR.
Conclusions:
- STARR effectively corrects rectal intussusception and reduces rectocele size.
- Despite morphological improvements, STARR did not fully resolve obstructed defecation symptoms in all patients.
- Further research is needed to understand the persistent functional deficits after STARR.
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