title: Short-term outcomes after rehabilitation treatment in patients selected by a novel rehabilitation score system (Brusciano score) with or without previous stapled transanal rectal resection (STARR) for rectal outlet obstruction.
abstract: OBJECTIVE
  The purpose of this study was to examine short-term outcomes of rehabilitation treatment in patients with or without previous stapled transanal resection (STARR) for rectal outlet obstruction by using a novel rehabilitation score system (Brusciano score).
  
  
  METHODS
  This is a retrospective cohort study conducted at a single tertiary referral institution including all patients with chronic functional constipation admitted to the outpatient unit from 2004 to 2009.
  
  
  RESULTS
  Among 330 consecutive patients, 247 (74.8 %) (204 females and 43 males) showing a significantly higher rehabilitation score (mean of 15.7 ± 1.8; range, 7-25) than healthy controls (mean, 3.2 ± 1.2; range 2-6) (p < .0001) were selected for rehabilitation. Of the 247 patients evaluated, group A (no previous surgery) consisted of 170 patients (53 males; mean age, 44.8 ± 12.9 years; range, 19-80) of which 38 presented mixed constipation, whereas group B (previous surgery) consisted of 77 patients (18 males; mean age, 47.0 ± 11.2 years; range, 22-81). The Brusciano score, Agachan-Wexner score and quality of life improved in both groups of patients after treatment. Better improvements of Brusciano and Agachan-Wexner scores were observed in patients with previous STARR (group B).
  
  
  CONCLUSIONS
  The rehabilitation score system employed in this study seems to be a useful tool in selecting and assessing the outcome of patients who might benefit from rehabilitation treatment. Constipation and quality of life were significantly improved by the rehabilitation treatment. Further studies are needed to clarify either the impact of rehabilitation treatment on long-term outcome of patients treated for rectal outlet obstruction or its role in those who develop problems over time.
authors.affiliation: XI Division of General and Obesity Surgery, Second University of Naples, Naples, Italy. luigibrusciano@tin.it
authors.forename: L
authors.initials: L
authors.lastname: Brusciano
authors.forename: P
authors.initials: P
authors.lastname: Limongelli
authors.forename: G
authors.initials: G
authors.lastname: del Genio
authors.forename: C
authors.initials: C
authors.lastname: Di Stazio
authors.forename: G
authors.initials: G
authors.lastname: Rossetti
authors.forename: S
authors.initials: S
authors.lastname: Sansone
authors.forename: S
authors.initials: S
authors.lastname: Tolone
authors.forename: F
authors.initials: F
authors.lastname: Lucido
authors.forename: A
authors.initials: A
authors.lastname: D'Alessandro
authors.forename: G
authors.initials: G
authors.lastname: Docimo
authors.forename: L
authors.initials: L
authors.lastname: Docimo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003248:Constipation / Q000000981:diagnostic imaging / Q000209:etiology; D019841:Defecography; D013505:Digestive System Surgical Procedures / Q000009:adverse effects / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000503:physiopathology / Q000534:rehabilitation* / Q000601:surgery*; D008297:Male; D008365:Manometry; D008875:Middle Aged; D012002:Rectal Diseases / Q000503:physiopathology / Q000534:rehabilitation* / Q000601:surgery*; D012007:Rectum / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D017792:Surgical Stapling / Q000009:adverse effects / Q000534:rehabilitation*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult