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经肛吻合直肠切除术(STARR)治疗出口梗阻型便秘综合征(ODS)的临床疗效:韩国单机构经验。

Clinical outcomes of stapled transanal rectal resection (STARR) for obstructed defecation syndrome (ODS): a single institution experience in South Korea.

机构信息

Department of Surgery, Daehang Hospital, 481-10, Bangbae3-dong, Seocho-gu, Seoul 137-820, South Korea.

出版信息

Int J Colorectal Dis. 2011 Jun;26(6):693-8. doi: 10.1007/s00384-011-1147-2. Epub 2011 Feb 11.

Abstract

PURPOSE

The purpose of this study was to assess both the short- and long-term functional outcomes of stapled transanal rectal resection (STARR) in ODS patients.

PATIENTS AND METHODS

We performed a retrospective review of data that were collected from January 2005 to October 2008. Between January 2005 to June 2006, 58 patients who underwent STARR were enrolled in this study. Follow-up was scheduled for 3 months and 1 year after surgery with the Cleveland Clinic Florida (CCF) constipation score and satisfaction grade. To evaluate the long-term functional outcome, we interviewed the patients by telephone using questionnaires for the CCF score and satisfaction grade on October 2008.

RESULTS

The median follow-up period was 34 months (range, 27-46 months). The mean age and sex ratio were 54 years (range, 19-85 years) and 8:50 (M/F). The mean CCF constipation scores were 17.6 before the surgery, 9.5 at 3 months, 9.6 at 12 months, and 10.3 at the time of the latest interview. The satisfaction grade, which was rated as excellent and good by 63.4% of the patients at the time of the latest interview, was worse than that at 3 months (37.8%). Among the cases of the excellent group (19 cases) at postoperative 3 months, 13 cases (68.4%) were classified as excellent or good at the time of the latest interview.

CONCLUSION

The STARR is a safe and effective surgical procedure for restoring the anatomy and function in ODS patients. Strict selection of patients is needed in enhancing and maintaining the patients' satisfaction after the procedure.

摘要

目的

本研究旨在评估吻合器经肛门直肠切除术(STARR)治疗出口梗阻型便秘(ODS)患者的短期和长期功能结果。

患者和方法

我们对 2005 年 1 月至 2008 年 10 月期间收集的数据进行了回顾性分析。2005 年 1 月至 2006 年 6 月期间,58 例行 STARR 的患者入组本研究。术后 3 个月和 1 年时采用克利夫兰诊所佛罗里达便秘评分(CCF)和满意度等级进行随访。为了评估长期功能结果,我们于 2008 年 10 月通过电话问卷的形式对患者进行了克利夫兰诊所佛罗里达便秘评分(CCF)和满意度等级的采访。

结果

中位随访时间为 34 个月(范围,27-46 个月)。患者的平均年龄和男女比例分别为 54 岁(范围,19-85 岁)和 8:50(M/F)。术前平均 CCF 便秘评分 17.6 分,术后 3 个月时为 9.5 分,12 个月时为 9.6 分,末次随访时为 10.3 分。末次随访时,63.4%的患者对治疗效果评价为优秀和良好,满意度较术后 3 个月时下降(37.8%)。术后 3 个月时的优秀组(19 例)中,13 例(68.4%)在末次随访时评价为优秀或良好。

结论

STARR 是一种安全有效的手术方法,可恢复 ODS 患者的解剖和功能。在增强和维持患者对术后疗效的满意度方面,需要对患者进行严格的选择。

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