Indikation, Technik und Ergebnisse der STARR-Operation

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• 作者：Prof. Dr. O. Schwandner ; P. Hillemanns
• 关键词：SchlüsselwörterObstruktives Defäkations ; Syndrom ; ODS ; rektale Intussuszeption ; STARR ; PPH01
• 刊名：Der Chirurg
• 出版年：2016
• 出版时间：November 2016
• 年：2016
• 卷：87
• 期：11
• 页码：909-917
• 全文大小：687 KB
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Surgery
  Cardiac Surgery
  Pediatric Surgery
  Plastic Surgery
  Traumatic Surgery
  Vascular Surgery
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1433-0385
• 卷排序：87

文摘

Rectal intussusception and ventral rectocele are frequent morphological findings in patients suffering from obstructed defecation syndrome (ODS). After failed conservative treatment a surgical option can be discussed. Surgical approaches include the stapled transanal rectal resection (STARR) procedure, which is performed as a transanal approach by using two circular (PPH01) staplers for ventral and dorsal full-thickness resection of the distal rectum. Both retrospective and prospective studies as well as data from the German STARR registry demonstrated that the STARR procedure is safe and effective for symptom improvement and resolution in ODS associated with rectal intussusception in the short-term; however, disappointing functional results, particularly related to fecal incontinence and urgency, severe complications and high rates of revision surgery have also been documented. In general, based on the diagnostic and therapeutic challenges in ODS related to rectal intussusception, patient selection for STARR seems to be the key for success; therefore, this review summarizes and evaluates the indications, surgical technique, results, controversies and current trends of the “conventional” STARR procedure using two circular (PPH01) staplers.