STARR surgery in treatment of SRUS: an observational study on clinical outcomes

Ashwin Porwal; Paresh Gandhi; Deepak Kulkarni

doi:10.18203/2349-2902.isj20180341

Authors

Ashwin Porwal Consultant Colorectal Surgeon, Healing Hand Clinic, Pune, Maharashtra, India
Paresh Gandhi Consultant Surgeon, Healing Hand Clinic, Pune, Maharashtra, India
Deepak Kulkarni Consultant Proctologist and Enterologist, Healing Hand Clinic, Pune, Maharashtra, India

DOI:

https://doi.org/10.18203/2349-2902.isj20180341

Keywords:

ODS, Recurrence rate, Rectal ulcer, SRUS, STARR surgery

Abstract

Background: SRUS is a condition with inadequately learned pathogenesis and usually associated with disorders of pelvic floor. Commonly seen in young adults and impairs quality of life. Because of these facts the management of SRUS is difficult and there is no clear consensus over it.

Methods: An observational, prospective study was planned at a single center with purposive sampling. All clinically diagnosed, histologically and endoscopically confirmed SRUS patients treated with STARR surgery and followed for two years. Data collected and analyzed to evaluate the effectiveness and patients satisfaction.

Results: Total of 46 patients with median age 47.8 years; of which 27 (58.70%) were females underwent STARR surgery. The average procedure time was 40 minutes, average length of stay was 24 hours and minimum duration of follow up was about 2 years (range 2-4 years). All patients had a pre-surgery history of digitations, which resolved in 91.3% patients post-surgery. There was a significant improvement in the ODS scores at the end of 2 years (82%; P <0.001). Excessive bleeding from staple line (48.57%), staple line dehiscence in 34.28% and staple line stricture (15.71% all males) are complications observed. No recurrence reported at the end of 4 years.

Conclusions: Short postoperative length of stay and the short time to return to work after the STARR procedure for management SRUS, minimal manageable complications, no recurrence and patient’s satisfaction makes STARR a cost-effective procedure.

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