Stuto Angelo, Renzi Adolfo, Carriero Alfonso, Gabrielli Francesco, Gianfreda Valeria, Villani Roberto Dino, Pietrantoni Carmine, Seria Giovanni, Capomagi Antonio, Talento Pasquale
UCP Ospedaliera Santa Maria Degli Angeli, Pordenone, Italy.
Surg Innov. 2011 Sep;18(3):248-53. doi: 10.1177/1553350610395035. Epub 2011 Feb 8.
This study was designed to evaluate the safety and efficacy of stapled trans-anal rectal resection (STARR) in the treatment of obstructed defecation syndrome ODS by the analysis of the data collected in the STARR Italian Registry (SIR) with a special emphasis on the analysis of symptoms and quality of life.
Collected data included, preoperative tests findings, and the evaluation of symptoms; the latter was obtained by using dedicated tools such as the Obstructed Defecation Syndrome Score (ODS-S), the Severity Symptom Score (SSS), and the Continence Grading Scale (CGS). Data on the quality of life were collected by Patient Assessment of Constipation Quality of Life (PAC-QoL) and the Euro Quality of Life-5 Domains Visual Analogue Scale (EQ-5D VAS). The evaluation of the symptoms and the quality of life was repeated 6 and 12 months after surgery.
The SIR had collected data on 2171 patients (1653 females, 76.1%; mean age 56.2 years; range 20-96 years). A significant improvement (P < .0001) was seen between preoperative and 12-month follow-up in all scores: ODS-S (16.7 vs. 5.0), SSS (15.6 vs. 2.6), CGS (2.0 vs. 0.7), PAC-QoL (51.0 vs. 22.1), and EQ-5D VAS (57.5 vs. 85.7). Complications included defecatory urgency (4.5% at 12 months), bleeding (3.6%), perineal sepsis (3.4%), and one case of rectovaginal fistula (0.05%).
The analysis of SIR data seems to confirm that STARR is a safe and effective procedure in the treatment of ODS. However, further studies are required to evaluate the long-term stability of results.
本研究旨在通过分析意大利吻合器经肛门直肠切除术（STARR）注册研究（SIR）中收集的数据，评估吻合器经肛门直肠切除术治疗排便障碍综合征（ODS）的安全性和有效性，特别着重于症状分析和生活质量评估。
收集的数据包括术前检查结果和症状评估；症状评估采用专用工具，如排便障碍综合征评分（ODS-S）、严重症状评分（SSS）和控便分级量表（CGS）。生活质量数据通过患者便秘生活质量评估（PAC-QoL）和欧洲五维健康量表视觉模拟评分（EQ-5D VAS）收集。术后6个月和12个月重复进行症状和生活质量评估。
SIR收集了2171例患者的数据（1653例女性，占76.1%；平均年龄56.2岁；范围20 - 96岁）。术前与12个月随访时所有评分均有显著改善（P < .0001）：ODS-S（16.7对5.0）、SSS（15.6对2.6）、CGS（2.0对0.7）、PAC-QoL（51.0对22.1）和EQ-5D VAS（57.5对85.7）。并发症包括排便急迫感（12个月时为4.5%）、出血（3.6%）、会阴感染（3.4%）和1例直肠阴道瘘（0.05%）。
对SIR数据的分析似乎证实STARR是治疗ODS安全有效的手术。然而，需要进一步研究评估结果的长期稳定性。
