폐쇄성 배변장애 증후군에서 자동문합기(PPH@)를 이용한 경항문 직장절제술(STARR)의 초기 성적
Early Experience with a Stapled TransAnal Rectal Resection for Obstructed Defecation Syndrome
신종근, 곽창신, 박정수, 최성일, 이재범, 박현주, 이소진, 이두한, 김도선,
소속 상세정보
신종근 ( Shin Jong-Keun )
대항병원 외과
곽창신 ( Kwak Chang-Shin )
대항병원 외과
박정수 ( Park Jung-Soo )
대항병원 외과
최성일 ( Choi Sung-Il )
대항병원 외과
이재범 ( Lee Jae-Bum )
대항병원 외과
박현주 ( Park Hyun-Joo )
대항병원 내과
이소진 ( Lee So-Jin )
대항병원 영상의학과
이두한 ( Lee Doo-Han )
대항병원 외과
김도선 ( Kim Do-Sun )
대항병원 외과
KMID : 0356720070230010001
Abstract
Purpose: This study was designed to assess the early outcome of a stapled transanal rectal resection (STARR) in obstructed defecation syndrome (ODS) patients with rectocele and rectal intussusception.
Methods: From January to December in 2005, 41 patients with the symptoms of obstructed defecation and the findings of rectocele and rectal intussusception in defecography, who failed in conservative management, were enrolled in this study. All patients underwent the STARR procedure. Preoperatively all patients received colonoscopy, a colon transit time test, cinedefecography, etc. The constipation score was evaluated by using the Cleveland Clinic Florida (CCF) constipation score preoperatively and at 1 month and 3 months after operation.
Results: The mean age of the patients was 55.3 (19∼76) years. There were three males and thirty-eight females. The mean operation time was 39.3 (25∼80) minutes, and the mean hospital stay was 4.2 (4∼6) days. Complications were fecal urgency in 9 cases (21.9%), which improved after 3 months, bleeding in 5 cases (12.2%), and anastomotic stenosis in 1 case (2.4%). At postoperative defecography, both intussusception and rectocele had disappeared in most patients. All constipation symptoms were significantly improved (P＜0.01). The mean CCF constipation score was 17.6 (11∼24) preoperatively, and improved to 9.1 after 1 month and 8.2 after 3 months (P＜0.01). The overall patient satisfaction was graded as excellent, good, fairly good and poor in 19 cases (46.3%), 13 cases (31.7%), 4 cases (9.7%), and 5 cases (12.2%), respectively.
Conclusion: The STARR procedure seems to be a safe and effective procedure in ODS patients with rectocele and rectal intussusception. However, further study of the long-term results is required. J Korean Soc Coloproctol 2007;23:1-9
키워드
폐쇄성 배변 장애 증후군;경항문 직장절제술;변비 점수
Obstructed defecation syndrome (ODS);Stapled transanal rectal resection (STARR);Constipation score
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