STARR手术治疗排便梗阻综合征临床疗效分析

Preview of the clinical effect of stapled transanal rectal resection(STARR)to treat obstructed defecation syndrome

目的 评价经肛吻合器直肠切除术（STARR）治疗排便梗阻综合征（ODS）的临床疗效.方法 回顾性分析行STARR手术治疗ODS 18例的临床资料.结果 本组患者平均随访时间38个月（4～68个月）,术前ODS评分从14.5±4.9到术后3个月降至5.9±5.0.随访期间,术后便秘症状改善61.1％（11例）,无效16.7％（3例）,术后复发22.2％（4例）,其中2例再次行手术治疗,1例再次行STARR手术治疗,1例行结肠切除回直肠吻合,术后便秘症状改善.术后并发症：急便感11.1％（2例）,肛门坠胀11.1％（2例）,无术后出血、感染、直肠阴道瘘、直肠狭窄等重大并发症.随访期间未见肛门失禁.术后治疗满意度72.2％.结论 STARR手术治疗ODS安全有效,创伤小,恢复快,并发症少.

Objective The efficacy of stapled transanal rectal resection （STARR） in treating the obstructed defecation syndrome（ODS） was evaluated.Methods Eighteen patients suffered ODS operated with STARR technique were ananlysed retrospectively.Results In the mean follow up of 38（4-68） months,the preoperative Longo ODS score was 14.5±4.9 vs.post 5.9±5.0 （P ＜0.001）.And the overall improvement rate was 61％,failure in 3 patients （16.7％）,recurrence in 4 patients （22.2％）.Reoperation was occurred in 2 patients.One patient repeated STARR,and the other one was perforemed total colectomy and ileorectal anastomosis.The symptoms were improved significantly after reoperation.The overall complication rate was 22.2％,fecal urgency in 2 patients （11.1％）,anaorectal heaviness in 2 （11.1％）.No major complications,including rectovaginal fistula,rectal senosis,perirectal abscess,occurred during follow up period.Anal incontinence also not encountered postoperatively.Patients＇ satisfaction rate was 72.2 ％.Conclusion The STARR procegure provide an safe and effective surgical option for the treatment of strictly selected patients with ODS.