Decision-making algorithm for the STARR procedure in obstructed defecation syndrome: position statement of the group of STARR Pioneers.
Internal rectal prolapse (rectal intussusception) and rectocele are frequent clinical findings in patients suffering from refractory constipation that may be best characterized as obstructive defecation syndrome. However, there is still no clear evidence whether the stapled transanal rectal resection (STARR) procedure provides a safe and effective surgical option for symptom resolution in patients with obstructive defecation syndrome, as evidence-based guidelines and functional long-term results are still missing. On the basis of the need for objective evaluation, a European group of experts was founded (Stapled Transanal Rectal Resection Pioneers). Derived from 2 meetings (October 26-28, 2006, Gouvieux, France and November 28-29, 2007, St Gallen, Switzerland) a concept for treatment options in patients suffering from obstructive defecation syndrome was developed, including a clear decision-making algorithm specifically focusing on the role of the stapled transanal rectal resection procedure based on clinical symptoms and dynamic imaging and inclusion and exclusion criteria for the stapled transanal rectal resection procedure.
Schwandner
Oliver
O
Department of Surgery, Caritas-Krankenhaus St. Josef, Regensburg, Germany. oschwandner@caritasstjosef.de
Stuto
Angelo
A
Jayne
David
D
Lenisa
Leonardo
L
Pigot
François
F
Tuech
Jean-Jacques
JJ
Scherer
Roland
R
Nugent
Karen
K
Corbisier
Fabrice
F
Basany
Eloy E
EE
Hetzer
Franc H
FH
D000465:Algorithms; D003248:Constipation / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D003661:Decision Support Techniques; D013505:Digestive System Surgical Procedures / Q000379:methods*; D005260:Female; D006801:Humans; D018579:Patient Selection; D012005:Rectal Prolapse / Q000150:complications; D020047:Rectocele / Q000150:complications; D012007:Rectum / Q000601:surgery; D017792:Surgical Stapling; D013577:Syndrome