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Purpose: The clinical and morphologic outcome of patients with obstructed defecation syndrome after stapled transanal rectal resection was prospectively evaluated., Methods: Twenty-four consecutive patients (22 women; median age, 61 (range, 36-74) years) who suffered from obstructed defecation syndrome and with rectal redundancy on magnetic resonance defecography were enrolled in the study. Constipation was assessed by using the Cleveland Constipation Score. Morphologic changes were determined by using closed-configuration magnetic resonance defecography before and after stapled transanal rectal resection., Results: After a median follow-up of 18 (range, 6-36) months, Cleveland Constipation Score significantly decreased from 11 (range, 1-23) preoperatively to 5 (range, 1-15) postoperatively (P = 0.02). In 15 of 20 patients, preexisting intussusception was no longer visible in the magnetic resonance defecography. Anterior rectoceles were significantly reduced in depth, from 30 mm to 23 mm (P = 0.01), whereas the number of detectable rectoceles did not significantly change. Complications occurred in 6 of the 24 patients; however, only two were severe (1 bleeding and 1 persisting pain requiring reintervention)., Conclusions: Clinical improvement of obstructed defecation syndrome after stapled transanal rectal resection correlates well with morphologic correction of the rectal redundancy, whereas correction of intussusception seems to be of particular importance in patients with obstructed defecation syndrome.

Background/aims: The objective of the present investigation is twofold: first, to assess how interdisciplinary tumour boards in Switzerland are designed, established, and rated in clinical practice; and second, to evaluate perceptions regarding the determination of cancer centres as required by the Swiss National Cancer Programme., Methods: An anonymous questionnaire was sent to the heads of surgical departments in Switzerland (n = 110). Among the clinics contacted were 11 large referral centres (type A clinics), 48 surgical departments of cantonal hospitals (type B clinics), and 51 regional surgical departments (type C clinics)., Results: For most type A and B clinics, tumour boards are held on a weekly basis (A: 100%, B: 88%, C: 26%). On average, 66% of respondents (A: 90%, B: 71 %, C: 52 %) consider tumour boards a standard of care for every cancer patient. Determination of cancer centres was favoured by 49% of all respondents (A: 80%, B: 56%, C: 32 %)., Conclusion: The present survey in Switzerland clearly shows significant differences between type A, B, and C clinics in the use of tumour boards and in their perception as a standard of care. There are wide discrepancies in the perceived need to determine cancer centres in Switzerland as required by the Swiss National Cancer Programme. Since the implementation of tumour boards is associated with optimised cancer patient care, continuing education on their importance is a vital necessity.