title: Long-term outcome after transanal rectal resection in patients with obstructed defecation syndrome.
abstract: BACKGROUND
  Stapled transanal rectal resection with a new, curved, multifire stapler (Transtar procedure) has shown promising short- and midterm results for treating obstructed defecation syndrome. However, few results have been published on long-term outcome.
  
  
  OBJECTIVE
  This study aimed to investigate long-term functional results and quality of life after the Transtar procedure.
  
  
  METHODS
  This is a retrospective study.
  
  
  METHODS
  This study was conducted at a tertiary hospital in Switzerland.
  
  
  METHODS
  Seventy consecutive patients (68 female) with obstructed defecation syndrome had a median age of 65 years (range, 20-90).
  
  
  METHODS
  The Transtar procedure was performed between January 2007 and March 2010.
  
  
  METHODS
  Postoperative functional results were evaluated with the Symptom Severity Score, Obstructed Defecation Score, and Cleveland Incontinence Score. Quality of life was evaluated with the Fecal Incontinence Quality of Life Score and the SF-36 Health Survey. Data were divided into 4 groups of 1-, 2-, 3-, and 4-year follow-ups.
  
  
  RESULTS
  The functional scores showed significant postoperative improvement throughout the studied period (p = 0.01). The quality-of-life scores showed a tendency for improvement only in the mental components on the SF-36 Health Survey (p = 0.01). Sixteen patients reported postoperative fecal urgency, but this subsided within a few months. Nine patients reported new postoperative episodes of incontinence and required further treatment.
  
  
  CONCLUSIONS
  This study was limited by its retrospective nature, the selection bias, and a bias by the small number of questionnaires available for some scores.
  
  
  CONCLUSIONS
  The Transtar procedure was successful for long-term treatment of obstructed defecation syndrome. Fecal urgency and incontinence were observed, but typically resolved within months. Therefore, the Transtar procedure appears to be a reasonable approach to treating obstructed defecation syndrome in the long term.
authors.affiliation: Department of Surgery, Cantonal Hospital St. Gallen, St. Gallen, Switzerland.
authors.forename: Susanne
authors.initials: S
authors.lastname: Bock
authors.forename: Katja
authors.initials: K
authors.lastname: Wolff
authors.forename: Lukas
authors.initials: L
authors.lastname: Marti
authors.forename: Bruno M
authors.initials: BM
authors.lastname: Schmied
authors.forename: Franc H
authors.initials: FH
authors.lastname: Hetzer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003248:Constipation / Q000601:surgery*; D003672:Defecation; D013505:Digestive System Surgical Procedures / Q000379:methods; D004867:Equipment Design; D005242:Fecal Incontinence / Q000601:surgery*; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012007:Rectum / Q000601:surgery*; D012189:Retrospective Studies; D015983:Selection Bias; D013528:Surgical Staplers; D017792:Surgical Stapling / Q000379:methods*; D013577:Syndrome; D016896:Treatment Outcome