Comparative outcome of stapled trans-anal rectal resection and macrogol in the treatment of defecation disorders

Table 1 Clinical presentations of the two study groups n (%)

	STARR n = 30 (F28)	Macrogol n = 30 (F30)	P value
Mean age (yr)	51 ± 9	53 ± 13
Duration of	24 (80)	26 (87)	0.7
constipation > 10 yr
Straining	28 (93)	29 (97)	1
Hard stools	27 (90)	29 (97)	0.6
Incomplete evacuation	27 (90)	27 (90)	0.7
Anal blockage	27 (90)	27 (90)	0.7
Digital facilitation	11 (37)	8 (27)	0.6
< 3 BM/wk	23 (77)	26 (87)	0.5
Laxatives	27 (90)	30 (100)	0.2
Rectal bleeding	13 (43)	7 (23)	0.2
Rectocele > 3 cm	23 (77)	15 (50)	0.06
Rectal intussusception	15 (50)	20 (67)	0.3

BM: Bowel movements.

Table 2 Presenting symptoms in responders and non-responders to stapled trans-anal rectal resection n (%)

	Responders	Non-responders	P value
Straining	16 (100)	12 (86)	0.4
Hard stools	14 (87)	13 (93)	0.9
Incomplete evacuation	16 (100)	11(78)	0.2
Anal blockage	15 (94)	12 (86)	0.9
Digital facilitation	4 (25)	7 (50)	0.3
< 3 BM/wk	13 (81)	10 (71)	0.8
Laxatives	14 (87)	13 (93)	0.9

BM: Bowel movements.

Table 3 Number of responders, degree of satisfaction, and Wexner constipation score variation during macrogol and after stapled trans-anal rectal resection treatment n (%)

	Macrogol	STARR	P value
Responders	22 (73)	16 (53)	0.2
Satisfaction			0.4
Total	18 (60)	16 (53)
Partial	5 (17)	9 (30)
Not satisfied	7 (23)	5 (17)
Δ Wexner score, mean ± SD	8 ± 5	6 ± 5.2	0.1

STARR: Stapled trans-anal rectal resection; Δ: Difference.

Table 4 Defecographic findings in responders and non-responders submitted to stapled trans-anal rectal resection (mean ± SD)

Variables	Before		After
	Non-responders	Responders	Non-responders	Responders
Rectal diameter (cm)	7.7 ± 1.4	7.3 ± 1	5.5 ± 0.9	5.8 ± 1.5
∆ ARA evacuation (°)	16 ± 8	25 ± 18	8.1 ± 20.3	28 ± 16.2a
PF at rest (cm)	5.1 ± 1.5	4.8 ± 1.3	4.3 ± 1.5	4.6 ± 1
PF during sqeezing (cm)	1.4 ± 0.7	1.3 ± 0.9	1.8 ± 0.9	1.2 ± 0.8
∆ PF evacuation (cm)	3.1 ± 1.6	3 ± 1.3	3.6 ± 1.1	3.1 ± 1.5
Rectocele (cm)	3.8 ± 1.8	4.1 ± 0.6	1.1 ± 1.6	1.7 ± 1.5
Anal diameter (cm)	1.4 ± 0.6	1.4 ± 0.8	1.3 ± 0.8	1.1 ± 0.4

ARA: Ano-rectal angle; PF: Pelvic floor; Δ: Difference;

^aP < 0.05 vs non-responders.