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Postoperative MR Defecography following Failed STARR Procedure for Obstructive Defecation Syndrome: A Three-Centre Experience

AIM: To describe the abnormalities at MR imaging and related complaints in patients with poor outcome after STARR procedure. MATERIALS AND METHODS: The medical records of 21 symptomatic patients from centre 1, 31 patients from centre 2, and 63 patients from centre 3 were reviewed with regard to find...

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Detalles Bibliográficos
Autores principales: Piloni, Vittorio, Possanzini, Marco, Bergamasco, Mattia, Santi, Gianluca
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5660778/
https://www.ncbi.nlm.nih.gov/pubmed/29158730
http://dx.doi.org/10.1155/2017/4392918
Descripción
Sumario:AIM: To describe the abnormalities at MR imaging and related complaints in patients with poor outcome after STARR procedure. MATERIALS AND METHODS: The medical records of 21 symptomatic patients from centre 1, 31 patients from centre 2, and 63 patients from centre 3 were reviewed with regard to findings at MR defecography and related symptoms. RESULTS: Regardless of the centre, most relevant imaging features and related complaints were (a) impaired emptying (82.11%), related complaint ODS; (b) persistent rectocele >2 cm and intussusception (39.3%), split evacuation and digitation; (c) pelvic organ descent on straining (39.8%), prolapse sensation; (d) small neorectum and loss of contrast (32.5%), urgency and incontinence; (e) anastomotic stricture and granuloma (28.4%), pain; and (f) nonrelaxing puborectalis muscle (19.5%), tenesmus. Less frequent findings included rectal pocket formation (5.6%) and rectovaginal sinus tract (1.6%). Patients were referred to MR imaging with an average time interval of 5 ± 2, 4 ± 1, and 2 ± 1 years in the three centres, respectively, and only rarely by the same surgeon who performed the operation: 1/21 (4.8%) in centre 1, 3/39 (7.7%) in centre 2, and 9/63 (14.3%) in centre 3. CONCLUSION: Most surgeons involved in STARR operation with subsequent poor outcome do not rely on MR imaging.