Stapled Transanal Rectal Resection for Outlet Obstruction: A Prospective, Multicenter Trial

Boccasanta, P; Venturi, Marco; Stuto, Angelo; Bottini, C.; Caviglia, Angelo; Carriero, A.; Mascagni, Domenico; Mauri, Roberto; Sofo, Luigi; Landolfi, V.

doi:10.1007/s10350-004-0582-3

Cited by 264 publications

(204 citation statements)

References 49 publications

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“…The novel procedure aims to correct rectocele, resects internal prolapse, restore anatomy, correct rectal volume, and improve function. 19 None of the available surgical treatments for solitary rectal ulcer associated with rectal conditions are satisfactory due to high recurrence rate. The stapled transanal rectal resection has been demonstrated to successfully cure patients with internal rectal prolapse associated with rectocele or prolapsed hemorrhoids.…”

Section: Discussionmentioning

confidence: 99%

STARR surgery in treatment of SRUS: an observational study on clinical outcomes

Porwal¹,

Gandhi²,

Kulkarni³

2018

Int Surg J

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Background: SRUS is a condition with inadequately learned pathogenesis and usually associated with disorders of pelvic floor. Commonly seen in young adults and impairs quality of life. Because of these facts the management of SRUS is difficult and there is no clear consensus over it.Methods: An observational, prospective study was planned at a single center with purposive sampling. All clinically diagnosed, histologically and endoscopically confirmed SRUS patients treated with STARR surgery and followed for two years. Data collected and analyzed to evaluate the effectiveness and patients satisfaction.Results: Total of 46 patients with median age 47.8 years; of which 27 (58.70%) were females underwent STARR surgery. The average procedure time was 40 minutes, average length of stay was 24 hours and minimum duration of follow up was about 2 years (range 2-4 years). All patients had a pre-surgery history of digitations, which resolved in 91.3% patients post-surgery. There was a significant improvement in the ODS scores at the end of 2 years (82%; P <0.001). Excessive bleeding from staple line (48.57%), staple line dehiscence in 34.28% and staple line stricture (15.71% all males) are complications observed. No recurrence reported at the end of 4 years.Conclusions: Short postoperative length of stay and the short time to return to work after the STARR procedure for management SRUS, minimal manageable complications, no recurrence and patient’s satisfaction makes STARR a cost-effective procedure.

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Section: Discussionmentioning

confidence: 99%

STARR surgery in treatment of SRUS: an observational study on clinical outcomes

Porwal¹,

Gandhi²,

Kulkarni³

2018

Int Surg J

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“…Important thing to note is that the incidence of undergoing surgery in patients with anterior RAI was similar to that with circular RAI. Various surgical procedures have been used to treat RAI such as the Delorme operation 17) , and more recently, STARR 18) , while perineal procedures are effective in alleviating OD, but are associated with recurrent prolapse, de novo urgency, and incontinence because of alterations in rectal compliance and possible dilatation of the anal sphincter. A consensus conference on the use of STARR 19) considered that anal incontinence was a contraindication to the procedure.…”

Section: Discussionmentioning

confidence: 99%

Proctographic findings and symptoms in patients with anterior rectoanal intussusception

Tsunoda

Takahashi

Hayashi

et al. 2017

J Anus Rectum Colon

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Abstract:Objectives: Rectoanal intussusception (RAI) is a common finding on defecography in patients with defecation disorders. This study aimed to compare the proctographic findings and symptoms between patients with anterior RAI and those with circular RAI. Methods: We included 208 patients who were diagnosed as having RAI on defecography. Anorectal function was evaluated using Constipation Scoring System (CSS) and Fecal Incontinence Severity Index (FISI). Results: Twenty-four patients had anterior RAI and 184 had circular RAI. While the anterior intussusception descent or pelvic floor descent was significantly smaller in patients with anterior RAI than those with circular RAI [14.3 vs. 18.5 mm, p=0.004; 12.4 vs. 21.6 mm, p= 0.005], there were no significant differences in incidences of obstructed defecation (OD) and fecal incontinence (FI) between the groups. Sixteen patients with anterior RAI and 137 patients with circular RAI had OD. There was no significant difference in the CSS scores between the groups. Twelve patients with anterior RAI and 108 patients with circular RAI had FI. No significant difference in the FISI scores between the groups. Conclusions: Approximately one tenth of the whole RAI was anterior in location, and symptoms in patients with anterior RAI were similar to those with circular RAI.

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“…The technique provides the opportunity to perform endorectal rectocele removal without the risks of transabdominal procedures. This novel technique seems to be safe and effective in the treatment of outlet obstruction caused by the combination of intussusception and rectocele 5,6,7,14 . Randomized trials are required to confirm these findings.…”

Section: Discusionmentioning

confidence: 99%

Combined parasacral, vaginal and endorectal approach in surgical treatment of giant rectocele

Korček¹,

Bakos²,

Farkas

2006

ACTA CHIR IUG

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In the present time two years after the surgery radiologic mean depth of the rectocele was significantly reduced (preoperatively 8cm; postoperatively 1 cm). Anorectal angle is 100 degrees. Values of the PN TML is normaly (left branch of n. pudendalis 1,7 msec and right branch of n. pudendalis 1,9 msec). Authors recorded Resting pressure 60 cm H 2O and Maximum squeeze pressure 110 cm H2O by anorectal manometry. They didnt visualized any external anal sphincters defect by anal ultrasound. Postoperatively difficult evacuation completely disappeared and digital support was no longer necessary during evacuation.

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Stapled Transanal Rectal Resection for Outlet Obstruction: A Prospective, Multicenter Trial

Abstract: This novel technique seems to be safe and effective in the treatment of outlet obstruction caused by the combination of intussusception and rectocele. Randomized trials are required to confirm these findings.

Cited by 264 publications

References 49 publications

STARR surgery in treatment of SRUS: an observational study on clinical outcomes

STARR surgery in treatment of SRUS: an observational study on clinical outcomes

Proctographic findings and symptoms in patients with anterior rectoanal intussusception

Combined parasacral, vaginal and endorectal approach in surgical treatment of giant rectocele

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