{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T13:27:46Z","timestamp":1760189266036},"reference-count":13,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2013,3,27]],"date-time":"2013-03-27T00:00:00Z","timestamp":1364342400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2013,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Stapled transanal rectal resection (<jats:styled-content style=\"fixed-case\">STARR<\/jats:styled-content>) is used for patients with obstructive defaecation syndrome (<jats:styled-content style=\"fixed-case\">ODS<\/jats:styled-content>) not responding to conservative management. Reports indicate mixed results and there are no studies publishing the long\u2010term outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Following full investigation, 37 patients with <jats:styled-content style=\"fixed-case\">ODS<\/jats:styled-content> underwent a <jats:styled-content style=\"fixed-case\">STARR<\/jats:styled-content> procedure by one of the authors (<jats:styled-content style=\"fixed-case\">SP<\/jats:styled-content>) between 2005 and 2010.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median (range) patient age was 53.0 (28\u201379) years and all were female. Median (range) follow up was 13 (0\u201357) months, and nine (24.3%) patients were followed for longer than 24\u00a0months. Eighteen patients had undergone at least one (and often multiple) previous gynaecological procedures, including hysterectomy (<jats:italic>n\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>14), colposuspension (<jats:italic>n\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>3), vaginal rectocele repair (<jats:italic>n\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>4) and pelvic floor repair (<jats:italic>n\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>5). Four patients had had at least one previous rectal operation [stapled anopexy (<jats:italic>n\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>3) and Delorme's procedure (<jats:italic>n\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>2)]. One patient did not attend for postoperative follow up. Of the remaining 36 patients, 18 had resolution of obstructive symptoms. Of the 18 with residual symptoms, 17 eventually reported the same level of symptoms as before the <jats:styled-content style=\"fixed-case\">STARR<\/jats:styled-content> procedure. There was a significant correlation between the presence of residual symptoms and long\u2010term <jats:styled-content style=\"fixed-case\">ODS<\/jats:styled-content> recurrence (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.0005). For those with residual symptoms, the mean (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>) time to symptom recurrence was 3 (2.86\u201311.81) months. Twenty (56%) patients were satisfied with the outcome from the <jats:styled-content style=\"fixed-case\">STARR<\/jats:styled-content> procedure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Residual symptoms are a strong indicator of long\u2010term failure. <jats:styled-content style=\"fixed-case\">STARR<\/jats:styled-content> was effective for symptom resolution in 50% of patients. Those who had undergone pelvic floor or rectal prolapse surgery were significantly more likely to experience recurrent symptoms.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.12054","type":"journal-article","created":{"date-parts":[[2012,10,11]],"date-time":"2012-10-11T17:41:43Z","timestamp":1349977303000},"page":"477-480","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Stapled transanal rectal resection (<scp>STARR<\/scp>) for obstructive defaecation syndrome: patients with previous pelvic floor surgery have poorer long\u2010term outcome"],"prefix":"10.1111","volume":"15","author":[{"given":"K.","family":"Adams","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery King's College Hospital London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Papagrigoriadis","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery King's College Hospital London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,3,27]]},"reference":[{"key":"e_1_2_6_2_1","unstructured":"LongoA.Obstructed defecation because of rectal pathologies. Novel surgical treatment: rectal resection (STARR). Proceedings of the 14th Annuall International Colo\u2010rectal Disease Symposium. 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