Dr Md Touhidul Islam, Assistant Professor (Colorectal Surgery), Mymensingh Medical College (MMC), Mymensingh, Bangladesh; E-mail:
Mymensingh Med J. 2022 Apr;31(2):355-359.
Obstructed defecation syndrome (ODS) is a common anorectal problem and it can be corrected by various surgical approaches but most of these have high recurrence and complication rates. Antonio Longo introduced Stapled transanal rectal resection (STARR) in 2003 as a minimally invasive transanal operation for correction ODS associated with rectocele and or rectal intussusception. This study was designed to assess the short term outcome of Stapled Transanal Rectal Resection (STARR) as a surgical treatment of Obstructed Defecation Syndrome (ODS). This is a quasi experimental study which was carried out in the department of Colorectal Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from May 2016 to June 2017. Seventeen (17) patients were included in the study. Patients with obstructed defecation syndrome and rectocele and or rectal intussusception admitted in the department of Colorectal Surgery were enrolled in the study as per inclusion and exclusion criteria. History, clinical examination, Proctoscopy, Colonoscopy and MR Defecography was done for evaluation of the patients. During evaluation preoperative Longo's ODS score of every patient also determined and compared with postoperative ODS score. The patient was followed up regularly at one, three and six months after each operation. The ODS score in 82.35% patients improved significantly. The postoperative score was high (13-15) only in 02(11.8%) patients probably due to presence of physiological factors. Post-operative defecatory urgency was developed in only 02(11.76%) patients. Major postoperative complication like hemorrhage or rectovaginal fistula did not develop in any patient. STARR is an effective, less invasive and simple procedure for the treatment of ODS with rectocele and/or rectal intussusception without major morbidity but other physiological causes of ODS should exclude preoperatively because its presence makes the surgical intervention fruitless.
梗阻性排便障碍综合征（ODS）是一种常见的肛肠问题，可以通过各种手术方法纠正，但大多数手术方法的复发率和并发症发生率都较高。2003 年，Antonio Longo 提出经肛直肠吻合术（STARR），作为一种微创经肛手术，用于纠正伴有直肠前突和/或直肠套叠的 ODS。本研究旨在评估经肛直肠吻合术（STARR）作为梗阻性排便障碍综合征（ODS）手术治疗的短期疗效。这是一项在孟加拉国达卡的 Bangabandhu Sheikh Mujib 医科大学肛肠外科进行的准实验研究，时间为 2016 年 5 月至 2017 年 6 月。共纳入 17 例患者。根据纳入和排除标准，将患有梗阻性排便障碍综合征和直肠前突和/或直肠套叠的患者纳入该研究。对患者进行病史、临床检查、直肠镜检查、结肠镜检查和磁共振排粪造影检查。在评估过程中，还对每位患者进行术前 Longo 排便障碍综合征评分，并与术后排便障碍综合征评分进行比较。术后定期对患者进行随访，每次随访时间为术后 1、3 和 6 个月。82.35%的患者排便障碍综合征评分显著改善。仅 02 例（11.8%）患者术后评分较高（13-15），可能与生理因素有关。仅 02 例（11.76%）患者术后出现排便急迫感。无严重术后并发症，如出血或直肠阴道瘘。STARR 是一种有效、微创、简单的治疗方法，适用于伴有直肠前突和/或直肠套叠的 ODS，且并发症发生率低，但应在术前排除 ODS 的其他生理病因，因为其存在会使手术干预无效。
