- 作者：Glenn M. Hall ; M.D. ; Glenn.Hall@uhhospitals.org" class="auth_mail ; Skandan Shanmugan ; M.D. ; Tamar Nobel ; B.S. ; Raj Paspulati ; M.D. ; Conor P. Delaney ; M.D. ; Ph.D. ; Harry L. Reynolds ; M.D. ; Sharon L. Stein ; M.D. ; Bradley J. Champagne ; M.D.
- 关键词：Obstructive defecation syndrome (ODS) ; Rectocele ; Magnetic resonance imaging defecography (MRID) ; Stapled transanal rectal resection (STARR)
- 刊名：The American Journal of Surgery
- 出版年：March, 2014
- 年：2014
- 卷：207
- 期：3
- 页码：375-379
- 全文大小：254 K
Background
The surgical indications for symptomatic rectocele are undefined, and surgery has high recurrence rates. We implemented magnetic resonance imaging defecography (MRID) to determine if utilizing strict inclusion criteria for rectocele repair improves outcomes.Methods
Patients with obstructive defecation syndrome (ODS) who underwent dynamic MRID were evaluated. Indications for surgical repair were defecation requiring manual assistance and the following MRID results: anterior defect >2 cm, incomplete evacuation, and the absence of perineal descent. Primary outcomes were the change in quality of life (QOL) scores and recurrence.
Results
From 2006 to 2013, 143 patients who presented with ODS underwent MRID. Seventeen patients met the criteria for repair. Recurrence was low (5.8%) with a median follow-up of 23 months, QOL scores improved from 57.3 to 76.5 (
Conclusions
A minority of patients (12%) with ODS met the above criteria for rectocele repair. Patients who underwent repair had a significant improvement in QOL and low recurrence rate.