STARR surgery in the treatment of rectocele and rectal intussusception

Authors: J. Örhalmi 1;  K. Klos 2;  A. Ferko 1;  S. Jackanin 2
Authors‘ workplace: Chirurgická klinika Lékařské fakulty UK v Hradci Králové a Fakultní nemocnice Hradec Králové přednosta: Prof. MUDr. A. Ferko, CSc. 1;  Vítkovická Nemocnice, a. s., Centrum péče o zažívací trakt, Chirurgické oddělení primář: Doc. MUDr. P. Holéczy, CSc. 2
Published in: Rozhl. Chir., 2012, roč. 91, č. 12, s. 649-653.
Category: Review

Podpořeno projektem (Ministerstva zdravotnictví) koncepčního rozvoje výzkumné organizace 00179906


Rectocele and intussusceptions are amongst the most frequent causes of Obstructed Defecation Syndrome (ODS). ODS diagnostics has been constantly improving which results in more precise indication criteria for individual surgical approaches. The work discusses indications for Stapled TransAnal Rectal Resection (STARR) as well as the results of the seven-year follow-up.

Material and methods:
Female patients with ODS score over 7 were indicated for STARR procedure after all conservative treatment possibilities failed. The proper indication requires that other causes of ODS be excluded. The retrospective analysis of prospectively collected data was employed.

Between January 2005 and October 2012 29 STARR procedures for rectocele were performed. Morbidity rate of the set of our patients was 6.9%. None of the patients died. We recorded bleeding from the staple line in seven patients (without surgical revision), and urinary infection in two patients. Bleeding from staple line was present in seven causes and urinary infection was present twice.

The STARR procedure seems to be an effective and safe treatment for ODS associated with rectocele and intussusception. The overall morbidity rate is low. Further investigation is required to optimize patientęs selection and to reduce the potential complications and failure during postoperative period.

Key words:
STARR – rectocele – Obstructed Defecation Syndrome - constipation


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