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The study was designed to assess safety and outcome of Stapled-transanal-rectal-resection (STARR) and internal Delormeprocedure for obstructive defaecation syndrome (ODS)A retrospective study using aprospective database included 34 ODS patients. 17 patients (Group A) underwent an internal Delorme and 17 (Group B) a STARRprocedure. Patients were evaluated using CCCS, ODS-score and PAC-QoL.There was no difference in age (STARR 53.8, Delorme 53.7 years). At a mean follow-up of 3.4 (Group A) and 3.9 years (group B) one recurrence was observed in Group B (5.8%). Fourteen (41.2%) patients developed postoperative complications 5 (29.4%) in Group A and 9 (52.9%) in Group B. These included suture-line dehiscence with stenosis (three in Group A),proctalgia (two in Group B), faecal incontinence (two in Group B), bleeding (two in Group B). Transient postoperative faecal urgency was higher in Group B (50%) (P = 0.001). Constipation scores improved significantly in both groups as did QoL (P = 0.001). The number of evacuations increased (47.1% vs 41.2% > 50% increment). Overall QoL was favourable (> 50% improvement) in 70.6% of Group A and in 52.9% of Group B (P = 0.001).Both techniques are safe and effective in the treatment of outlet obstruction. The internal Delormeprocedure appears more effective with fewer complications.