Assessing the safety, effectiveness, and quality of life after the STARR procedure for obstructed defecation: results of the German STARR registry

Abstract

These data indicate that STARR is a safe and effective procedure. However, conclusions are limited due to the selection and reporting bias of a registry. The problem of fecal urgency needs cautious reassessment.

Surgical management of rectal prolapse

“…Furthermore, the issue whether surgery can resolve symptoms is controversial. If surgery is indicated, a variety of approaches including transabdominal (rectopexy with/ without resection, with/without mesh) and transrectal procedures such as Delorme's operation have been proposed [2]. Delorme's operation has been used in the past for elderly patients with concomitant diseases, which made the transabdominal approach a high risk procedure.…”

“…Also previous small series resulted unsatisfactory functional outcome and serious complications that have major impact on the popularity of the procedure. However, according to the German STARR registry study group, STARR seems to be a safe procedure in the majority of cases, with a 21.1% rate of morbidity, but they report conservative management for most cases, without the need for surgical intervention [2]. However, other authors report the need for reinterventions, such as Hartmann procedure, to treat pelvic sepsis following rectal perforation [3].…”

Acupuncture in Treatment of Chronic Functional Constipation

“…For example, to evaluate STARR in obstructed defecation syndrome, the primary responder endpoint collection is the obstructed defecation score (ODS) reduction ≥ 50% at one year, the secondary endpoint is PAC-QOL (Patient Assessment of Constipation Quality of Life questionnaire) and a continence grading scale. (The operation may result in faecal incontinence and this needs to be demonstrated [59]. The same efficacy evaluation parameters, however, are not suitable for acupuncture treatment.…”

Indikationen und chirurgische Therapieoptionen beim obstruktiven Defäkationssyndrom

“…Es muss jedoch auch darauf hingewiesen werden, dass die Inzidenz der «fecal urgency» nach STARROperation, die bei 10-20% der Patientinnen auftritt, ein beachtliches Problem darstellt und noch nicht gelöst ist [36,48,49]. Zudem haben Fallberichte über schwere chirurgische Komplikationen (Nachblutung, retroperitoneales Hämatom, rektovaginale Fistel) bzw.…”