<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_1905-7415.0902.378_s_004_s_001_w2aab3b7b1b1b6b1aab1c16b1Aa"><h3>Background</h3><p>Stapled transanal rectal segmental resection (STARR) is a technique for treatment of obstructive defecation syndrome (ODS) when associated with rectocele and/or intussusceptions.</p></sec><sec id="j_1905-7415.0902.378_s_004_s_002_w2aab3b7b1b1b6b1aab1c16b2Aa"><h3>Objectives</h3><p>To evaluate a simplified method using a single stapler device for isolated anterior rectal wall correction of structural abnormalities (single-STARR technique).</p></sec><sec id="j_1905-7415.0902.378_s_004_s_003_w2aab3b7b1b1b6b1aab1c16b3Aa"><h3>Materials and methods</h3><p>Patients who were diagnosed with ODS underwent the single-STARR procedure. Their baseline symptoms were measured by using a modified obstructed defecation syndrome (MODS) questionnaire score. Evacuation proctography was performed to exclude functional anorectal disorders. Colonoscopy was selectively performed and for all patients older than 50 years. Single-STARR procedure was performed in cases where there was no evidence of an inflammatory, metabolic, neoplastic process, or functional disorders. The summed global score of ODS ranged from 0 (normal) to 24 (severe). Outcomes were determined by evaluating the postoperative improvement using a MODS score.</p></sec><sec id="j_1905-7415.0902.378_s_004_s_004_w2aab3b7b1b1b6b1aab1c16b4Aa"><h3>Results</h3><p>A total of 9 patients (mean (SD) age 53 (13.6) years) with ODS were eligible for the study. Both rectocele and intussusceptions were diagnosed from preoperative defecography in 7 of the patients. Single-STARR was successfully performed without intraoperative complications in all patients with a mean operative time of 52 (12.7) min. The mean severity of symptoms decreased significantly at the 3<sup>rd</sup> and 6<sup>th</sup> (<italic>P</italic> &lt; 0.01) month after surgery. However, one-third of patients experienced persistence of symptoms or symptom score deterioration on the 12<sup>th</sup> month after surgery.</p></sec><sec id="j_1905-7415.0902.378_s_004_s_005_w2aab3b7b1b1b6b1aab1c16b5Aa"><h3>Conclusion</h3><p>The single-STARR procedure provided short-term symptom relief with no serious postoperative complication in a small series of 9 cases.</p></sec></abstract>

BackgroundStapled transanal rectal segmental resection (STARR) is a technique for treatment of obstructive defecation syndrome (ODS) when associated with rectocele and/or intussusceptions.ObjectivesTo evaluate a simplified method using a single stapler device for isolated anterior rectal wall correction of structural abnormalities (single-STARR technique).Materials and methodsPatients who were diagnosed with ODS underwent the single-STARR procedure. Their baseline symptoms were measured by using a modified obstructed defecation syndrome (MODS) questionnaire score. Evacuation proctography was performed to exclude functional anorectal disorders. Colonoscopy was selectively performed and for all patients older than 50 years. Single-STARR procedure was performed in cases where there was no evidence of an inflammatory, metabolic, neoplastic process, or functional disorders. The summed global score of ODS ranged from 0 (normal) to 24 (severe). Outcomes were determined by evaluating the postoperative improvement using a MODS score.ResultsA total of 9 patients (mean (SD) age 53 (13.6) years) with ODS were eligible for the study. Both rectocele and intussusceptions were diagnosed from preoperative defecography in 7 of the patients. Single-STARR was successfully performed without intraoperative complications in all patients with a mean operative time of 52 (12.7) min. The mean severity of symptoms decreased significantly at the 3rd and 6th (P < 0.01) month after surgery. However, one-third of patients experienced persistence of symptoms or symptom score deterioration on the 12th month after surgery.ConclusionThe single-STARR procedure provided short-term symptom relief with no serious postoperative complication in a small series of 9 cases.

Short-term outcomes after anterior stapling rectotomy using a single stapler device for rectocele

Asian Biomedicine

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

BackgroundStapled transanal rectal segmental resection (STARR) is a technique for treatment of obstructive defecation syndrome (ODS) when associated with...

	Number (n)	Sum of total scor mean (SD)	P
Baseline	8	16.87 (2.69)	0.012 Statistically significant using a Wilcoxon signed-ranks test
3^rd month	8	8.50 (5.92)
Baseline	7	16.86 (2.91)	0.018 Statistically significant using a Wilcoxon signed-ranks test
6^th month	7	9.43 (5.72)
Baseline	7	16.86 (2.91)	0.063
12^th month	7	9.43 (5.91)

Question and response options	Score

	1	2	3	4
1. Medication to evacuate (enemas or suppositories)	Never	< 1/week	1-6/weeks	Everyday
2. Difficulties to evacuate	Never	< 1/week	1-6/weeks	Everyday
3. Digitation to evacuate	Never	< 1/week	1-6/weeks	Everyday
4. Return to toilet to evacuate	Never	< 1/week	1-6/weeks	Everyday
5. Feeling of incomplete evacuation	Never	< 1/week	1-6/weeks	Everyday
6. Straining/push to evacuate	Never	Sometimes	Often	Always
7. Time needed to evacuate	<5 min	6-10 min	11-20 min	>20 min
8. Lifestyle alteration	Never	Sometimes	Often	Always

Symptoms	Immediate	1^st month	3^rd month
Defecatory urgency	0	1	1
Acute urinary retention	1	0	0
Anal fissure	0	0	1

No.	Age	Sex	Defecographic	Operative time	MODS	MODS

			findings	(min)	Baseline	3^rdmo	6^thmo	12^thmo
1	54	F	Rectocele Intussusception	55	17	13	13	15
2	33	F	Rectocele Intussusception	45	11	2	2	16
3	47	F	Rectocele Intussusception	65	18	16	16	15
4	62	F	Rectocele Intussusception	55	17	1	-	-
5	61	F	Rectocele Intussusception	55	16	10	10	-
6	57	F	Rectocele	50	17	2	1	2
7	55	F	Rectocele	25	16	_-	_-	3
8	53	F	Rectocele Intussusception	55	20	11	11	7
9	41	F	Rectocele	55	19	13	13	8

Short-term outcomes after anterior stapling rectotomy using a single stapler device for rectocele

Article Category: Original article

Published Online: Jan 31, 2017

Page range: 133 - 138

DOI: https://doi.org/10.5372/1905-7415.0902.378

Keywords
Obstructive defecation syndrome, rectocele, stapled transanal rectal segmental resection

© 2017 Sahaphol Anannamcharoen, Kanchana Areerattanavet

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Figure 1

Preoperative and postoperative symptoms evaluated by MODS questionnaire

Modified ODS patient questionnaire

Postoperative complications in patients undergoing Single-STARR

Defecographic findings and operative time in ten patients undergoing Single-STARR

Short-term outcomes after anterior stapling rectotomy using a single stapler device for rectocele

Article Category: Original article

Published Online: Jan 31, 2017

Page range: 133 - 138

DOI: https://doi.org/10.5372/1905-7415.0902.378

KeywordsObstructive defecation syndrome, rectocele, stapled transanal rectal segmental resection

© 2017 Sahaphol Anannamcharoen, Kanchana Areerattanavet

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Figure 1

Preoperative and postoperative symptoms evaluated by MODS questionnaire

Modified ODS patient questionnaire

Postoperative complications in patients undergoing Single-STARR

Defecographic findings and operative time in ten patients undergoing Single-STARR

Keywords
Obstructive defecation syndrome, rectocele, stapled transanal rectal segmental resection