Quality of life after treatment of rectal intussusception or rectocele by means of STARR

Abstract

AIM: Stapled Transanal Rectal Resection (STARR) has been proposed for surgical treatment of rectal intussusception and rectocele. This study aims at evaluating the effect of the STARR on symptoms of obstructed defecation and associated faecal incontinence regarding the impact on the quality of life of patients with rectal intussusception and rectocele.

MATHERIALS AND METHODS: Twentynine patients with rectal intussusception and 22 with rectocele, who underwent to STARR in the General Surgery of the University of L’Aquila - Italy, are the subjects of the study. Symptoms of obstructive defecation were reported in all cases; with associated faecal incontinence in 31%. Questionnaires as ODS-Score , PAC-QoL, FISI and FIQL were proposed to all 51 patients before surgical treatment and at 3 years from operation.

RESULTS: ODS-Score decreased from 28 ± 3.66 preoperatively to 6.7 ± 5.77 postoperatively ( p< 0.001), while PACQoL score was 14 ± 1.4 preoperatively vs 5.3 ± 1.7 postoperatively ( p<0.0020). The lower score indicates a lower severity index and an excellent quality of life. FISI score arose from 16.13 ± 5.39 before surgery to 19.33 ± 2.31 after surgery while, in the group of patients with preoperative symptoms of faecal incontinence, it arose from 7.86 ± 2.89 to 16.4 ± 4.5 after surgery (p< 0.0039). FIQL score sum was 105 ± 75 preoperatively vs 225 ± 90 postoperatively. The lower score indicates a higher severity index and a lower quality of life.

CONCLUSIONS: Patients with rectal intussusception or rectocele may improve their symptoms and quality of life undergoing to the STARR.