title: [Stapled transanal rectal resection (STARR) in the treatment of rectocele: personal experience].
abstract: Rectocele is an organic cause of chronic constipation, with a prevalence ranging from 8.95% to 12% in Europe and United States. Necessarily, the approach for rectocele repair is a surgical operation. Stapled transanal rectal resection (STARR) is safe and effective in the treatment of obstructed defecation syndrome. The authors' experience suggests that the surgical operation needs to be combined to rehabilitation exercises, before and after the surgical treatment, in order to strengthen the muscles of the pelvic pavement. From January 2005 to January 2007, 20 patients with outlet obstruction underwent STARR. Patients were selected for operation based on a strict diagnostic protocol: anamnesis, clinical examination, coloproctological and urogynaecological examinations, defecography, anorectal manometry, transrectal ultrasonography and peritoneal electromyography. The therapeutic protocol consists of 3 parts: phase I: rehabilitation of the pelvic pavement; phase II: surgical operation; III phase: post-surgical rehabilitation of the pelvic pavement; The clinical result was classified into: excellent (6 patients), when all constipation symptoms disappeared, good (11 patients), when patient has 1 or 2 obstructed defecation episodes treated with a laxative, fairly good (2 patients), more than 2 episodes, and poor (1 patient), when surgical operation doesn't improve any of the symptoms. Our results, confirmed by the literature, suggest that Longo's technique should be considered as gold standard for rectocele treatment.
authors.affiliation: Dipartimento di Chirurgia e Bioingegneria, Sezione di Chirurgia, Università degli Studi di Siena, Policlinico Le Scotte, Siena.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Guarnieri
authors.forename: Manuela
authors.initials: M
authors.lastname: Cesaretti
authors.forename: Andrea
authors.initials: A
authors.lastname: Tirone
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Vuolo
authors.forename: Luigi
authors.initials: L
authors.lastname: Verre
authors.forename: Vinno
authors.initials: V
authors.lastname: Savelli
authors.forename: Alessandro
authors.initials: A
authors.lastname: Piccolomini
authors.forename: Leonardo
authors.initials: L
authors.lastname: Di Cosmo
authors.forename: Anton Ferdinando
authors.initials: AF
authors.lastname: Carli
authors.forename: Mariagrazia
authors.initials: M
authors.lastname: Burroni
authors.forename: Marcella
authors.initials: M
authors.lastname: Pitzalis
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal; D005260:Female; D006801:Humans; D008875:Middle Aged; D020047:Rectocele / Q000601:surgery*; D017792:Surgical Stapling / Q000379:methods