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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Main Authors: Vittorio Piloni, Marco Possanzini, Mattia Bergamasco, Gianluca Santi
Format: Article
Language:English
Published: Wiley 2017-01-01
Series:Gastroenterology Research and Practice
Online Access:http://dx.doi.org/10.1155/2017/4392918
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author Vittorio Piloni
Marco Possanzini
Mattia Bergamasco
Gianluca Santi
author_facet Vittorio Piloni
Marco Possanzini
Mattia Bergamasco
Gianluca Santi
author_sort Vittorio Piloni
collection DOAJ
description 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.
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spelling doaj-art-aec50e1385f64c20a4daf09a6c2fee132025-02-03T00:59:46ZengWileyGastroenterology Research and Practice1687-61211687-630X2017-01-01201710.1155/2017/43929184392918Postoperative MR Defecography following Failed STARR Procedure for Obstructive Defecation Syndrome: A Three-Centre ExperienceVittorio Piloni0Marco Possanzini1Mattia Bergamasco2Gianluca Santi3Radiologist Diagnostic Imaging Centre, Iniziativa Medica, Monselice, Padua, ItalyTechnician Diagnostic Imaging Centre, Villa Igea Clinic, Ancona, ItalyTechnician Diagnostic Imaging Centre, Iniziativa Medica, Monselice, Padua, ItalyTechnician Diagnostic Imaging Centre, Studio Ronconi, Acilia, Rome, ItalyAim. 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.http://dx.doi.org/10.1155/2017/4392918
spellingShingle Vittorio Piloni
Marco Possanzini
Mattia Bergamasco
Gianluca Santi
Postoperative MR Defecography following Failed STARR Procedure for Obstructive Defecation Syndrome: A Three-Centre Experience
Gastroenterology Research and Practice
title Postoperative MR Defecography following Failed STARR Procedure for Obstructive Defecation Syndrome: A Three-Centre Experience
title_full Postoperative MR Defecography following Failed STARR Procedure for Obstructive Defecation Syndrome: A Three-Centre Experience
title_fullStr Postoperative MR Defecography following Failed STARR Procedure for Obstructive Defecation Syndrome: A Three-Centre Experience
title_full_unstemmed Postoperative MR Defecography following Failed STARR Procedure for Obstructive Defecation Syndrome: A Three-Centre Experience
title_short Postoperative MR Defecography following Failed STARR Procedure for Obstructive Defecation Syndrome: A Three-Centre Experience
title_sort postoperative mr defecography following failed starr procedure for obstructive defecation syndrome a three centre experience
url http://dx.doi.org/10.1155/2017/4392918
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