title: Complications and reinterventions after surgery for obstructed defecation.
abstract: OBJECTIVE
  Functional results following surgery for obstructed defecation (OD) have been widely investigated, but there are few reports aimed to analyze postoperative complications and re-interventions. This study investigates the adverse events requiring retreatment for obstructed defecation.
  
  
  METHODS
  We retrospectively analyzed the records of 203 patients operated on by a single surgeon, 20 transabdominally and 183 transperineally (159 manual and 24 stapled). Postoperative complications requiring retreatment and outcome of reinterventions were analyzed.
  
  
  RESULTS
  Adverse events requiring retreatment occurred in 14.3% more frequently after abdominal than after perineal procedures (20% vs. 13.7%), but the sample size of the two arms is different. Rectal bleeding and strictures were the most common adverse events (6.9%). Major complications, i.e., ischemic colitis requiring hemicolectomy and pelvic sepsis requiring colostomy also occurred (1%). The overall reintervention rate was 7.5%, (5% after abdominal and 7.6% after perineal surgery). Overall, 59% of the reoperated patients were still constipated at a median follow up of 2 years.
  
  
  CONCLUSIONS
  Complications requiring retreatment are not uncommon after surgery for OD and reinterventions are often unsuccessful. A careful preoperative evaluation and selection of patients should be undertaken in order to minimize adverse events.
authors.affiliation: Coloproctology Unit, Ars Medica and Villa Flaminia Hospitals, Rome, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Pescatori
authors.forename: Giovanni
authors.initials: G
authors.lastname: Milito
authors.forename: Marina
authors.initials: M
authors.lastname: Fiorino
authors.forename: Federica
authors.initials: F
authors.lastname: Cadeddu
mesh_terms: D000005:Abdomen / Q000601:surgery; D000328:Adult; D000368:Aged; D003248:Constipation / Q000503:physiopathology / Q000601:surgery*; D003672:Defecation; D013505:Digestive System Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010502:Perineum / Q000601:surgery; D020127:Recovery of Function; D012002:Rectal Diseases / Q000503:physiopathology / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome