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)yrs54.1 (12.5)56.7(14.6)0.421
Preop.ODS score18.5 (3.1)18.1 (3.5)0.583
OutcomeControlStudyp- value
POP, mean(SD)
D133.5(8.5)30.7(12.4)0.276
D269.2(10.8)70.0(11.7)0.780
D351.6(11.8)51.7(11.2)0.967
W130.6(10.1)29.6(8.4)0.653
W325.3(7.0)22.6(7.5)0.135
M38.5(7.9)8.1(8.2)0.822
Y16.3(6.4)6.5(6.7)0.864
Y35.26(6.05) 5.5(6.4) 0.874
FUI,mean(SD)
W15.11(2.4)5.19(1.6)0.886
W3 to Y14.23(1.78)4.78(1.45)0.172
Y32.71(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

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