Tailored prolapse surgery for the treatment of hemorrhoids with a new dedicated device: TST Starr plus

Naldini, Gabriele; Fabiani, Bernardina; Menconi, Claudia; Giani, Iacopo; Toniolo, G. Chechile; Martellucci, Jacopo

doi:10.1007/s00384-015-2314-7

Cited by 17 publications

(12 citation statements)

References 35 publications

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“…This device could reduce the recurrence rate through the possibility of more tissue resection basis of the entity of the prolapse 23 . Naldini, et al reported that 1.9% prolapsed recurrence after operation in a median follow-up of 14.5 months 40 . This series also showed no occurrence of anorectal stricture and it could be due to the larger diameter of stapler (36 mm) than PPH (33 mm) or DST (33 mm).…”

Section: Discussionmentioning

confidence: 99%

Comparison of the short-term outcomes of using DST and PPH staplers in the treatment of grade III and IV hemorrhoids

Wang

Kiu

Yen

et al. 2020

Sci Rep

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Stapled hemorrhoidopexy has a few advantages such as less postoperative pain and faster recovery compared with conventional hemorrhoidectomy. there are two major devices used for stapled hemorrhoidopexy, ppH stapler (ethicon endoSurgery) and DSt stapler (covidien). this study was conducted to investigate the postoperative outcomes among patients with grade iii and iV hemorrhoids who underwent hemorrhoidopexy with either of these two devices. A total of 242 consecutive patients underwent stapled hemorrhoidopexy with either PPH stapler (110 patients) or DST stapler (132 patients) at a single center in 2017. We performed a retrospective case-control study to compare the short-term postoperative outcomes and the complications between these two groups. After matching the cases in terms of age, gender, and the grade of hemorrhoids, there were 100 patients in each group (PPH versus DST). There were no significant differences in the postoperative visual analog scale (VAS) score and analgesic usage. Among complications, the incidence of anorectal stricture was significantly higher in the DSt group (p = 0.02). Evaluation of the mucosal specimen showed that the total surface area, the muscle/mucosa ratio and the surface area of the muscle were also significantly higher in the DSt group (p = 0.03). Further analysis of the DST group demonstrated that patients with anorectal stricture after surgery are younger than patients without anorectal stricture, and higher muscle/mucosa ratio (p = 0.03) and a higher surface area of the muscle (p = 0.03) also measured in the surgical specimen. the two devices provide similar outcomes of postoperative recovery. patients who underwent DSt stapled hemorrhoidopexy had a higher incidence rate of stricture, larger area of muscle excision, and higher muscle/mucosa ratio in the surgical specimen. further investigation is warranted for a better understanding of the correlation between muscle excision and anorectal stricture.

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Section: Discussionmentioning

confidence: 99%

Comparison of the short-term outcomes of using DST and PPH staplers in the treatment of grade III and IV hemorrhoids

Wang

Kiu

Yen

et al. 2020

Sci Rep

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“…There are different types of surgical procedure to treat hemorrhoids according to the symptoms and anatomical presentation. In fact, nowadays there is an open debate about the right operation to perform focusing on a tailored treatment of hemorrhoids [3]. One of the most spread procedure for circumferential prolapse is stapled hemorrhoidopexy.…”

Section: Discussionmentioning

confidence: 99%

“…It is reported an higher recurrence rate than the conventional hemorrhoidectomy [1] even if the patients usually refer an high grade of satisfaction. It is also characterized by low postoperative pain, shorter hospital stay and faster return to work [3].…”

Section: Discussionmentioning

confidence: 99%

Mucocele complicating stapled hemorrhoidopexy

Grapsi

Sturiale

Fabiani

et al. 2017

International Journal of Surgery Case Reports

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“…Although the circular stapled hemorrhoidopexy was also based on the above theory, because of complications such as urgency [15] and anal stenosis [16], surgeons are often reluctant to use PPH. Recent studies have proven the merits of TST, treating prolapsing hemorrhoids without any significant risk [1, 3, 6, 10]. Therefore, TST can be used widely.…”

Section: Discussionmentioning

confidence: 99%

“…Hemorrhoids were classified into the following stages [9]: (I) anal cushions protruding into the anal canal but maintaining at the proper level, (II) prolapse with bowel movements but with spontaneous reduction, (III) prolapse with bowel movements but requiring manual reduction, and (IV) prolapse but not reducible. Patients with chronic fissure, acute thrombosis, fixed fibrous external hemorrhoids, abscess, benign rectal disease, colorectal carcinoma, anal strictures, and severe primary diseases were not included in the study [10]. HIV-infected patients were selected on the basis of hemorrhoids being their only perianal disease.…”

Section: Methodsmentioning

confidence: 99%

Treatment of Prolapsing Hemorrhoids in HIV-Infected Patients with Tissue-Selecting Technique

Fan,

Zhang

2017

Gastroenterology Research and Practice

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The aim of this retrospective study was to evaluate the outcome of a tissue-selecting therapy stapler (TST) for prolapsing hemorrhoids in HIV-infected patients. Sixty-two patients with stage III-IV hemorrhoidal prolapse were treated with TST by a single surgeon between June and November 2014. The TST group comprised 32 patients (4 females), and the TST + HIV group comprised 30 HIV-infected patients (3 females). Age, gender, and preoperative examination as well as intraoperative and postoperative features were assessed. There was no marked difference in hemorrhoidal prolapse between the TST and HIV + TST groups, except for patient satisfaction at 12 months. TST is an effective and safe technique for treatment of prolapsing hemorrhoids in HIV-infected patients.

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Tailored prolapse surgery for the treatment of hemorrhoids with a new dedicated device: TST Starr plus

Abstract: TST Starr plus seems to be safe and effective for a tailored transanal stapled surgery for the treatment of III-IV degree hemorrhoidal prolapse. The new conformation and innovative technology of the stapler seems to reduce some postoperative complications and recurrence rate.

Cited by 17 publications

References 35 publications

Comparison of the short-term outcomes of using DST and PPH staplers in the treatment of grade III and IV hemorrhoids

Comparison of the short-term outcomes of using DST and PPH staplers in the treatment of grade III and IV hemorrhoids

Mucocele complicating stapled hemorrhoidopexy

Treatment of Prolapsing Hemorrhoids in HIV-Infected Patients with Tissue-Selecting Technique

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