Effect of Continuing Yoga Practice on the Adverse Patient Reported Outcomes Following Stapled Trans-Anal Resection of the Rectum (starr) for Obstructed Defecation Syndrome(ods)

Nayan Agarwal, Mr, Satish Saluja, MD, Brij B Agarwal, MD, Shruti Sharma, Dr, Kamran Ali, Dr, Karan Goyal, Dr, Himanshu Pandey, MD

University College of Medical Sciences, Sir Ganga Ram Hospital,and Dr. Agarwal’s Surgery

INTRODUCTION – To study the beneficial or harmful impact of continuing Yoga practice on Adverse patient reported outcomes (APROs) following Staples Trans-Anal Resection of the Rectum (STARR) procedure done on patients with Obstructed Defecation Syndrome (ODS).

METHODS AND PROCEDURES –A prospective cohort study (April 2008 –June 2009) of APROs of Post-Operative Pain (POP) and Fecal Urge Incontinence (FUI)- following STARR in consenting ODS patients selected and operated following standard diagnostic/ imaging and pre-postoperative protocols respectively. The patients were divided into control (not practicing Yoga) and study (practicing Yoga >3months) groups. Data for POP(100 point visual analogue scale) & FUI (20 point Wexner score) were entered into excel sheet during postoperative evaluation at day-1(D1), day-2(D2), day-3 (D3), week-1(W1), week-3 (W3), month-3 (M3), year-1 (Y1) & year-3 (Y3), for analysis using SPSS17.0. Student’s t-test & chi square test were used for continuous and categorical variables respectively.

RESULTS–

	No Yoga(n=35)	Yoga (n=32)	p value
Gender,n(%) Male Female	28 (80) 7 (20)	18 (58.6) 14 (43.8)	0.036
Age,mean(SD)yrs	54.1 (12.5)	56.7(14.6)	0.421
Preop.ODS score	18.5 (3.1)	18.1 (3.5)	0.583

Outcome	Control	Study	p- value
POP, mean(SD)
D1	33.5(8.5)	30.7(12.4)	0.276
D2	69.2(10.8)	70.0(11.7)	0.780
D3	51.6(11.8)	51.7(11.2)	0.967
W1	30.6(10.1)	29.6(8.4)	0.653
W3	25.3(7.0)	22.6(7.5)	0.135
M3	8.5(7.9)	8.1(8.2)	0.822
Y1	6.3(6.4)	6.5(6.7)	0.864
Y3	5.26(6.05)	5.5(6.4)	0.874
FUI,mean(SD)
W1	5.11(2.4)	5.19(1.6)	0.886
W3 to Y1	4.23(1.78)	4.78(1.45)	0.172
Y3	2.71(1.65)	0.63(1.15)	0.000

All female patients reported a fear of incontinence while sitting in a cross-legged squatting position leading to a felt need to change their traditional working position from a squat to sitting on a chair.

CONCLUSION-Continuing the practice of yoga by patients undergoing STARR has no harmful or beneficial effect on APROs except for FUI related benefit after 3 years.

Session: Poster Presentation

Program Number: P033