Analysis Of Psychological Assessment Inventory And Anus And Colorectal Dynamics Of Improved STARR Surgical Treatment Of The Rectocele

Objective:To study the probable pathogenesis and the treatment of the elderly female patients with rectocele.To offer theoretical basis of the stapling resection of rectum anus (improved STARR) in clinical treatment.Methods:Retrospective analysis the clinical data of20healthy volunteers and50rectocele patients treated by Improved STARR,who are diagnosed by defecography and anorectal manometry (defecography results belong to Ⅱ-Ⅲ degrees) in our Colorectal&Anal Surgery Department from March2014to January2015. Based on the principle of volunteer,we collected the data of ODS score, Hamilton anxiety scale (HAMA) and Hamilton depression scale (HAMD) and the anorectal manometry result pre-operation two weeks and3months after operation. We also collected the data of defecography result pre-operation and3months after operation. Observe the clinical curative effect, at the same time observe the postoperative complications, and evaluate its treatment efficacy, and safety.Results:a) The study found that there is a certain tendency of anxiety or depression of psychological barriers in aged female rectocele patients.The results shows that:44cases’Hamilton depression rating scale (HAMD) scores more than seven points before operation,which means these44patients have depressive mental disorder, accounting for68.75%of the total number.38patients have mild depression (86.36%),6patients have moderate depression(13.64%).58cases’Hamilton anxiety scale (HAMA) scores more than14points before operation,which means these58patients have anxiety mental disorder, accounting for90.63%of the total number.40patients have mild anxiety(62.50%),18patients have moderate anxiety(28.13%).Cases scores were significantly higher than the control group in each period.b) In terms of psychological assessment, after treatment of Improved STARR, the patients’HAMA and HAMD scores are presented the change of first fall after rise.c) The ODS scores after treatment are significantly reduced than pre-operation.50patients reexamined defecography3month after operation(14lost to follow-up),the results shows that both rectocele and rectal internal mucosa prolapse are well-treated.There’s no statistically significant difference between groups of sphincter length (P>0.05):The case group2weeks after the operation, the initial perception threshold, maximal tolerance threshold, initial defecation threshold was significantly lower than that before operation and the control group (P<0.05).3months after operation, the initial perception threshold, maximal tolerance threshold, initial defecation threshold rose significantly. Conclusions:Elderly female rectocele patients always existence of anorectal dynamics change and anxiety, depression and other psychological and mental disorders. Improved STARR treatment is effective to these changes.