Savastano Silvia, Valenti Giuseppe, Cavallin Francesco, Missaglia Claudio
Coloproctology Service, Eretenia Private Hospital, Vicenza, Italy.
Surg Innov. 2012 Jun;19(2):171-4. doi: 10.1177/1553350611425504. Epub 2011 Nov 10.
The stapled transanal rectal resection (STARR) procedure is safe and effective.
To compare STARR performed with PPH-01 (STARR) and CCS 30 (Transtar).
Sixty-four patients underwent STARR for obstructed defecation syndrome (32 STARR and 32 Transtar) and were observed from January 2007 to June 2009. Patients were studied by visit with questionnaires, colonoscopy or barium enema, defecography, and anorectal manometry. Postoperatively they were assessed through visit and questionnaires.
All patients improved symptoms without statistical differences. The obstructed defecation syndrome score changed from 13 to 1.8 at 6 months and to 1 at 1 year in the STARR group (P < .05), and the score changed from 15 to 2 at 6 months and to 1 at 1 year in the Transtar group (P < .05). There were no intraoperative complications in the STARR group, but there were 2 dehiscences of suture in the Transtar group. There were no differences with regard to complications.
Transtar is a more complex technique with more severe complications. A major resection is not always more effective.
吻合器经肛门直肠切除术(STARR)安全有效。
比较使用PPH - 01(STARR)和CCS 30(Transtar)进行的STARR手术。
2007年1月至2009年6月,64例因排便障碍综合征接受STARR手术的患者(32例行STARR手术,32例行Transtar手术)被纳入观察。通过问卷调查、结肠镜检查或钡剂灌肠、排粪造影和肛肠测压对患者进行研究。术后通过随访和问卷调查对患者进行评估。
所有患者症状均有改善,无统计学差异。STARR组排便障碍综合征评分在术后6个月时从13降至1.8,1年时降至1(P <.05);Transtar组评分在术后6个月时从15降至2,1年时降至1(P <.05)。STARR组术中无并发症,但Transtar组有2例缝线裂开。两组并发症方面无差异。
Transtar技术更为复杂,并发症更严重。大范围切除并不总是更有效。