Zhao Ke, Ding Jian-hua, Song Wei-liang, Zhu Jun, Yin Shu-hui, Tang Hai-yan
Department of Colorectal Surgery, the General Hospital of the Second Artillery of People's Liberation Army, Beijing 100088, China.
Zhonghua Wai Ke Za Zhi. 2009 Dec 15;47(24):1846-8.
To evaluate the effectiveness and safety of stapled transanal rectum resection (STARR) in the treatment of obstructed defecation syndrome (ODS).
Fifty-six patients with ODS who had rectocele and/or intussusception were treated with STARR from January 2007 to August 2008. The incidence of preoperative and postoperative symptoms of ODS was compared. Symptomatic relief was also observed by using scoring system.
The average operation time was 28 min, and in the first 3 days after operation the average VAS pain score was 3.2 points. Two patients experienced mild anal incontinence when followed-up to 6 months; 2 patients suffered mild anal pain during defecation due to slight anastomotic inflammation 2 and 4 months after the operation, respectively. No other complications was found. The mean follow-up period was 8 months after surgery, and the rate of symptoms of ODS reduced significantly compared with that before surgery, in particular the incidence of the difficult and obstructive defecation feelings decreased for more than 50 percent (P<0.05). Compared with that before the operation, the sense of no emptying stool decreased for 65 percent and all the other symptoms reduced for more than 72 percent (all P<0.05).
The stapled transanal rectum resection is simple, less invasive, less painful and with fewer complications and more satisfactory recent effect in treating obstructed defecation syndrome.
评估经肛门吻合器直肠切除术（STARR）治疗排便障碍综合征（ODS）的有效性和安全性。
2007年1月至2008年8月，对56例患有直肠膨出和/或直肠套叠的ODS患者采用STARR进行治疗。比较术前和术后ODS症状的发生率。还通过评分系统观察症状缓解情况。
平均手术时间为28分钟，术后前3天平均视觉模拟评分（VAS）疼痛评分为3.2分。随访至6个月时，2例患者出现轻度肛门失禁；术后2个月和4个月，分别有2例患者因轻微吻合口炎症在排便时出现轻度肛门疼痛。未发现其他并发症。术后平均随访8个月，ODS症状发生率较术前显著降低，尤其是排便困难和梗阻感的发生率下降超过50%（P<0.05）。与术前相比，排便不尽感下降65%，其他所有症状下降超过72%（均P<）。
经肛门吻合器直肠切除术治疗排便障碍综合征操作简单、创伤小、疼痛轻、并发症少，近期效果较满意。
