title: Stapled transanal rectal resection vs. transvaginal rectocele repair for treatment of obstructive defecation syndrome.
abstract: OBJECTIVE
  Stapled transanal rectal resection has been introduced as a new technology for the management of obstructive defecation syndrome. In this study we observed the clinical outcomes for stapled transanal rectal resection as compared with transvaginal rectocele repair for obstructive defecation syndrome.
  
  
  METHODS
  This study is a retrospective review of patients who received transvaginal rectocele repair for obstructive defecation syndrome from June 1997 to February 2002 as compared with patients who received stapled transanal rectal resection from June 2005 to August 2007. The clinical outcomes observed were operative time, estimated blood loss, length of stay, complication rate, procedure failure rate, recurrence rate, time to recurrence, and dyspareunia rate.
  
  
  RESULTS
  Thirty-seven patients had transvaginal rectocele repair for management of obstructive defecation syndrome, and 36 patients had stapled transanal rectal resection. There was no difference in the age of patients receiving either procedure (transvaginal rectocele repair, 57.92 years old; stapled transanal rectal resection, 53.19 years old; P = 0.1096). Evaluation of the clinical outcomes showed that transvaginal rectocele repair had a longer operative time (transvaginal rectocele repair, 85 minutes; stapled transanal rectal resection, 52 minutes; P = or<0.0001), greater estimated blood loss (transvaginal rectocele repair, 108 ml; stapled transanal rectal resection, 43 ml; P = 0.0015), and a lower complication rate (transvaginal rectocele repair, 18.9 percent; stapled transanal rectal resection, 61.1 percent; P = 0.0001).
  
  
  CONCLUSIONS
  The stapled transanal rectal resection procedure can be done with shorter operative times and less blood loss than transvaginal rectocele repair, however, it has a higher complication rate.
authors.affiliation: Colon and Rectal Clinic of Orlando, Orlando Regional Health System, Orlando, Florida, USA. marsha.harris@nyumc.org
authors.forename: Marsha A
authors.initials: MA
authors.lastname: Harris
authors.forename: Andrea
authors.initials: A
authors.lastname: Ferrara
authors.forename: Joseph
authors.initials: J
authors.lastname: Gallagher
authors.forename: Samuel
authors.initials: S
authors.lastname: DeJesus
authors.forename: Paul
authors.initials: P
authors.lastname: Williamson
authors.forename: Sergio
authors.initials: S
authors.lastname: Larach
mesh_terms: D001003:Anal Canal / Q000601:surgery; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D003248:Constipation / Q000503:physiopathology / Q000601:surgery*; D019841:Defecography; D013505:Digestive System Surgical Procedures / Q000379:methods*; D006801:Humans; D008019:Life Style; D008875:Middle Aged; D012189:Retrospective Studies; D017792:Surgical Stapling; D013577:Syndrome; D016896:Treatment Outcome