Obstructed Defecation Syndrome does the Starr Procedure Take Place? Technical and Functional Facts

Volume 4 - Issue 1

Gerardo Martín Rodríguez¹* and Pablo Piccinini²

Received: December 02, 2019   Published: December 16, 2019

DOI: 10.32474/SCSOAJ.2019.04.000180

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Summary

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

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