title: Stapled trans-anal rectal resection (STARR) in the surgical treatment of the obstructed defecation syndrome: results of STARR Italian Registry.
abstract: OBJECTIVE
  This study was designed to evaluate the safety and efficacy of stapled trans-anal rectal resection (STARR) in the treatment of obstructed defecation syndrome ODS by the analysis of the data collected in the STARR Italian Registry (SIR) with a special emphasis on the analysis of symptoms and quality of life.
  
  
  METHODS
  Collected data included, preoperative tests findings, and the evaluation of symptoms; the latter was obtained by using dedicated tools such as the Obstructed Defecation Syndrome Score (ODS-S), the Severity Symptom Score (SSS), and the Continence Grading Scale (CGS). Data on the quality of life were collected by Patient Assessment of Constipation Quality of Life (PAC-QoL) and the Euro Quality of Life-5 Domains Visual Analogue Scale (EQ-5D VAS). The evaluation of the symptoms and the quality of life was repeated 6 and 12 months after surgery.
  
  
  RESULTS
  The SIR had collected data on 2171 patients (1653 females, 76.1%; mean age 56.2 years; range 20-96 years). A significant improvement (P < .0001) was seen between preoperative and 12-month follow-up in all scores: ODS-S (16.7 vs. 5.0), SSS (15.6 vs. 2.6), CGS (2.0 vs. 0.7), PAC-QoL (51.0 vs. 22.1), and EQ-5D VAS (57.5 vs. 85.7). Complications included defecatory urgency (4.5% at 12 months), bleeding (3.6%), perineal sepsis (3.4%), and one case of rectovaginal fistula (0.05%).
  
  
  CONCLUSIONS
  The analysis of SIR data seems to confirm that STARR is a safe and effective procedure in the treatment of ODS. However, further studies are required to evaluate the long-term stability of results.
authors.affiliation: UCP Ospedaliera Santa Maria Degli Angeli, Pordenone, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Stuto
authors.forename: Adolfo
authors.initials: A
authors.lastname: Renzi
authors.forename: Alfonso
authors.initials: A
authors.lastname: Carriero
authors.forename: Francesco
authors.initials: F
authors.lastname: Gabrielli
authors.forename: Valeria
authors.initials: V
authors.lastname: Gianfreda
authors.forename: Roberto Dino
authors.initials: RD
authors.lastname: Villani
authors.forename: Carmine
authors.initials: C
authors.lastname: Pietrantoni
authors.forename: Giovanni
authors.initials: G
authors.lastname: Seria
authors.forename: Antonio
authors.initials: A
authors.lastname: Capomagi
authors.forename: Pasquale
authors.initials: P
authors.lastname: Talento
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003248:Constipation / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D011788:Quality of Life; D012002:Rectal Diseases / Q000150:complications* / Q000503:physiopathology; D012007:Rectum / Q000601:surgery*; D012042:Registries; D012307:Risk Factors; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D017792:Surgical Stapling; D011795:Surveys and Questionnaires; D013577:Syndrome; D016896:Treatment Outcome