Brij B Agarwal, MD, Shruti Sharma, Dr, Nayan Agarwal, Mr, Kamran Ali, Dr, Karan Goyal, Dr, Krishna A Agarwal, Mr, Satish Saluja, MD, Himanshu Pandey
Sir Ganga Ram Hospital, Dr. Agarwal’s Surgery, University College of Medical Sciences, Vardhman Mahavir Medical College
INTRODUCTION: This study was undertaken to evaluate the efficacy and safety of stapled trans-anal rectal resection (STARR) for the management of obstructed defecation syndrome (ODS) in Asian (Indian) patients.
METHODS AND PROCEDURES: A prospective cases series (April 2008-June 2009) of consecutive consenting STARR candidates suffering with ODS evaluated according to a standardized clinical and imaging protocol with well defined inclusion and exclusion criteria, operated following a standard peri-operative protocol. The patients were operated using PPH03 intruments and followed for improvements in ODS scores and adverse events (as per patient maintained diaries) at week (W) 1, W3, month (M) 3, M6, Year (Y) 1 and Y3. Relationship if any between ODS scores, defecographic findings and intraoperative assessment of rectal intussusception length (IRIL) was studied. The clinical data was analysed with standard statistical tools.
|Age(SD) Yrs.||Males;57.6(13.1)||Females;50.8(13.1)||p value;0.04|
|Rectal Intussusception||8(17.4)||6 (28.6)||0.296|
|Anterior Rectocele||36(78.3)||19 (90.5)||0.226|
|Posterior Rectocele||36(78.3)||2 (9.5)||0.709|
|IRIL cms.(SD)||2.3 (0.7)||2.4 (0.7)||0.534|
CONCLUSION: STARR is an effective procedure for ODS in Asian population. The improvement in ODS scores is sustainable. Demonstrable internal rectal prolapse / rectal intussusceptions is a good predictor of favorable outcomes. Late onset of new pain after 3 months needs further study.
Session: Poster Presentation
Program Number: P039