Clinical research of improved STARR in the treatment of moderate and severe rectocele
10.3760/cma.j.issn.1008-6706.2016.16.026
- VernacularTitle:改良 STARR 术治疗中重度直肠前突的疗效观察
- Author:
Xionghua XIANG
;
Yanping QING
;
Lili LIU
;
Weimin WU
;
Haibo JIN
;
Zhangyu CAI
- Publication Type:Journal Article
- Keywords:
Rectocele;
Obstructed defecation syndrome;
STARR;
Sehapayak
- From:
Chinese Journal of Primary Medicine and Pharmacy
2016;23(16):2499-2504
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the therapeutic effect of improved STARR (Sehapayak as a control)in the treatment of moderate and severe rectocele.Methods 70 patients diagnosed with rectocele from Jan.2015 to Oct. 2015 were selected and randomly divided into 2 groups,35 cases in each group.They were treated with either improved STARR or Sehapayak surgery.The operation time,intraoperative blood loss,postoperative pain scores, patients'satisfaction and hospitalization days were compared between 2 groups.The ODS scores and therapeutic effects were compared in 1st week,1st month,3rd month and 6th month after treatment.The defecography was implemented and compared between 2 groups before treatment and 1st week and 6th month after treatment.Results The operation time,intraoperative blood loss,postoperative pain scores,hospitalization days and time to return to work were signifi-cantly lower in STARR group than those in Sehapayak group[(29.76 ±8.40)min vs (48.38 ±9.04)min;(14.43 ± 8.16)mL vs (77.80 ±20.58)mL;(4.29 ±1.76)points vs (6.71 ±2.04)points;(6.71 ±1.22)d vs (11.23 ± 3.64)d;(7.20 ±1.36)d vs (13.14 ±2.60)d;t =8.934,16.935,5.338,6.955,11.959,all P <0.05],and the patients'satisfaction was significantly higher in STARR group[(8.83 ±0.98)points vs (7.54 ±1.20)points,t =4.908,P <0.05].There were no significant differences in efficacy between 2 groups at any time point (P >0.05). The ODS score was (20.97 ±4.38)points before treatment,(4.71 ±1.30)points 1week after treatment,(2.94 ± 0.91)points 1month later,(1.68 ±1.04)points 3months later and (0.97 ±0.88)points 6mons later in the observa-tion group.The ODS scores in the control group were (19.88 ±4.09)points,(4.65 ±1.28)points,(3.51 ±1.15) points,(2.88 ±1.67)points,(1.85 ±1.31)points,respectively.The postoperative ODS scores of the two groups of patients were compared with the preoperative decreased significantly (t =20.666,23.904,26.127,26.401,all P <0. 05;t =22.882,24.081,24.032,25.015,all P <0.05),but at 1 week after operation of the two groups of ODS score had no statistically significant difference (P >0.05);1 month,3 months and 6 months after surgery,the differences of ODS score of the two groups were statistically significant(t =2.313,3.585,323.3,all P <0.05).The depth of recto-cele in the observation group was (33.09 ±6.79)mm before treatment,(5.54 ±1.96)mm 1month after treatment and (6.67 ±1.95 )mm 6months after treatment;while (33.57 ±6.46)mm,(7.65 ±2.11 )mm and (9.32 ± 2.74)mm in the control group,respectively.There was no difference between the two groups in the depth of rectocele before treatment (P >0.05).After treatment,they were all significantly decreased (t =21.779,20.646,all P <0.05;t =25.261,20.768,all P <0.05)in the two groups,and compared with the control group,the observation group decreased more significantly(t =4.339,4.565,all P <0.05 ).The two groups of patients at months after the 6th month of the rectal protrusion were significantly higher than the 1st months after the surgery (t =2.864,3.113,all P <0.05).The incidence rate of side effects was significantly higher in STARR group than that in Sehapayak group 1st week after treatment (48.6% vs.22.9%,χ2 =5.040,P =0.025),but there was no difference in 6th month after treatment (8.1% vs.3.0%,P >0.05).Conclusion Compared with Sehapayak,improved STARR surgery has the advantage of excellent curative effects,less trauma,shorter hospitalization,less complications and higher patient satis-faction.Improved STARR surgery is conducive to the prevention of rectocele relapse.
