Obstructed Defecation Syndrome does the Starr
Procedure Take Place? Technical and Functional Facts
Volume 4 - Issue 1
Gerardo Martín Rodríguez1* and Pablo Piccinini2
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- 1Staff Surgeon and Endoscopist, Clínica Del Angelo, Argentina
- 2Consultant Surgeon, CEMIC, Ciudad Autónoma de Buenos Aires, Argentina
Gerardo Martín Rodríguez, Staff Surgeon and Endoscopist, Clínica Del Angelo Formosa, Argentina
Received: December 02, 2019 Published: December 16, 2019
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Background: constipation due to bowel obstruction in the outflow tract aims to correct the anatomy and functionality of the
pelvic floor in the posterior side. Among several approaches, the STARR technique (Stapled Trans Anal Rectocele Resection) has
valid foundations in order to solve them.
Objectives: to communicate the experience with the technique in a center of Argentina and analize its feasibility, results and
review the current evidence.
Design: prospective and consecutive
Materials and Methods: between January 2009 and January 2019 Starr was used in 30 patients diagnosed with constipation
due to bowel obstruction in the outflow tract –Obstructed defecation syndrome - (ODS) caused by rectocele with or without
rectoanal intussusception. We analyse the demographic variables, indications, technique, morbidity rate and functional results.
Results: 100% of the people who had surgery were women. The average age in all the procedures was about 58,5 years old.
The tecnique was performed as ambulatory surgery in the 6% percent of the cases. The global index of complications was of 30%
percent, which was grouped according to the Dindo-Clavien classification. Severe complications or morbidity weren’t registered.
30% percent of the patients presented recurrence of the symptoms after more than six months follow up, eventhough all of them
solved through fingering or manoeuvre in order to empty the bowels and improved the quality of life.
Conclusion: Starr tecnique is and effective and safe procedure for the treatment of constipation due to ODS. It could be carried
out as outpatient basis. The correct indication and experience in the handling of mechanical sutures are essential. The recurrence of
symptoms is probably associated with functional and neuromuscular disorders devoloped by the patients.
Keywords: Constipation; oubstructed defecation syndrome; surgery; starr
Material and Methods|