A Modification of the Stapled TransAnal Rectal Resection (STARR) Procedure for Rectal Prolapse
A Modification of the Stapled TransAnal Rectal Resection (STARR) Procedure for Rectal Prolapse
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直肠脱垂吻合器经肛门直肠切除术 (STARR) 手术的改良
DOI：
10.1177/1553350618793415
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发表时间：
2018-12-01
影响因子：
1.5
通讯作者：
Ren, Dong-Lin
中科院分区：
文献类型：
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作者：
Lin, Hong-Cheng;Chen, Hua-Xian;Ren, Dong-Lin
目的。本研究旨在评估改良的钉接式经肛门直肠切除术（改良的STARR）在局限性直肠外脱垂患者中的安全性、有效性和术后结果。方法。回顾性分析了2014年2月至2016年9月间采用组织选择技术吻合器经肛直肠切除术（TSTStarr Plus）吻合器进行直肠切除术的轻度直肠脱垂患者的前瞻性队列。结果。25例符合条件的患者使用TSTStarr Plus吻合器行直肠切除术。切除标本的中位垂直高度为5.0 cm（范围为3.1-10 cm），所有病例均经组织学证实为全层切除。随访33.6±9.4个月，复发1例（4%）。与术前评分相比，术后Wexner平均评分显著提高（术前：中位数= 3，范围= 0-20，术后：中位数= 2，范围= 0-20,P = 0.010）。术前症状严重程度评分中位数和排便障碍评分中位数均较术后评分降低（P = 0.001）。结论。改良STARR治疗轻度直肠脱垂是一种安全有效的技术。初步结果将鼓励对该技术进行更正式的前瞻性评估，作为轻度直肠脱垂治疗的随机试验的一部分。
Purpose. This study was designed to assess the safety, efficacy, and postoperative outcomes of the modified Stapled TransAnal Rectal Resection (modified STARR) in patients presenting with cases of limited external rectal prolapse. Methods. A prospective cohort of patients with mild rectal prolapse undergoing rectal resection with the Tissue-Selecting Technique Stapled TransAnal Rectal Resection Plus (TSTStarr Plus) stapler between February 2014 and September 2016 was reviewed retrospectively. Results. Twenty-five eligible patients underwent rectal resection with the TSTStarr Plus stapler. The median vertical height of the resected specimen was 5.0 cm (range = 3.1-10 cm) with all cases being confirmed histologically as full-thickness resections. Over a follow-up of 33.6 ± 9.4 months, only 1 case (4%) was encountered with recurrence. The mean postoperative Wexner score was significantly improved when compared with the preoperative scores (preoperative: median = 3, range = 0-20, vs postoperative: median = 2, range = 0-20, respectively; P = .010). The median preoperative Symptom Severity Score and Obstructed Defecation Score were both decreased compared with the postoperative scores (P = .001). Conclusions. Modified STARR in management of mild rectal prolapse appear to be a safe and effective technique. The initial results would encourage a more formal prospective assessment of this technique as part of a randomized trial for the management of mild rectal prolapse.