title: Resected specimen evaluation, anorectal manometry, endoanal ultrasonography and clinical follow-up after STARR procedures.
abstract: OBJECTIVE
  To investigate stapled transanal rectal resection (STARR) procedures as surgical techniques for obstructed defecation syndrome (ODS) by analyzing specimen evaluation, anorectal manometry, endoanal ultrasonography and clinical follow-up.
  
  
  METHODS
  From January to December 2007, we have treated 30 patients. Fifteen treated with double PPH-01 staplers and 15 treated using new CCS 30 contour. Resected specimen were measured with respect to average surface and volume. All patients have been evaluated at 24 mo with clinical examination, anorectal manometry and endoanal ultrasonography.
  
  
  RESULTS
  Average surface in the CCS 30 group was 54.5 cm² statistically different when compared to the STARR group (36.92 cm²). The average volume in the CCS 30 group was 29.8 cc, while in the PPH-01 it was 23.8 cc and difference was statistically significant. The mean hospital stay in the CCS 30 group was 3.1 d, while in the PPH-01 group the median hospital stay was 3.4 d. As regards the long-term follow-up, an overall satisfactory rate of 83.3% (25/30) was achieved. Endoanal ultrasonography performed 1 year following surgery was considered normal in both of the studied groups. Mean resting pressure was higher than the preoperative value (67.2 mmHg in the STARR group and 65.7 mmHg in the CCS30 group vs 54.7 mmHg and 55.3 mmHg, respectively). Resting and squeezing pressures were lower in those patients not satisfied, but data are not statistically significant.
  
  
  CONCLUSIONS
  The STARR procedure with two PPH-01 is a safe surgical procedure to correct ODS. The new Contour CCS 30 could help to increase the amount of the resected tissue without differences in early complications, post-operative pain and in hospital stay compared to the STARR with two PPH-01 technique.
authors.affiliation: Fourth Unit of Surgery, Santa Chiara Hospital of Pisa, 56124 Pisa, Italy. g.naldini@ao-pisa.toscana.it
authors.forename: Gabriele
authors.initials: G
authors.lastname: Naldini
authors.forename: Guido
authors.initials: G
authors.lastname: Cerullo
authors.forename: Claudia
authors.initials: C
authors.lastname: Menconi
authors.forename: Jacopo
authors.initials: J
authors.lastname: Martellucci
authors.forename: Simone
authors.initials: S
authors.lastname: Orlandi
authors.forename: Nicola
authors.initials: N
authors.lastname: Romano
authors.forename: Mauro
authors.initials: M
authors.lastname: Rossi
mesh_terms: D003672:Defecation / Q000502:physiology; D013505:Digestive System Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008136:Longevity; D008365:Manometry / Q000379:methods*; D008875:Middle Aged; D010149:Postoperative Pain / Q000453:epidemiology / Q000209:etiology; D015995:Prevalence; D012002:Rectal Diseases / Q000503:physiopathology / Q000601:surgery*; D012007:Rectum / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D017792:Surgical Stapling / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D016896:Treatment Outcome; D014463:Ultrasonography / Q000379:methods*