Objective: The stapled transanal rectal resection (STARR) in patients with defecation disorders is limited by the shape and capacity of the circular stapler. A new device has been recently developed, the Contour Transtar stapler, in order to improve the safety and effectiveness of the STARR technique. The study has been designed to confirm this declaration.

Method: From January to June 2007 a prospective European multicentre study of consecutive patients with defecation disorder caused by internal rectal prolapse underwent the new STARR technique. The assessment of perioperative morbidity and functional outcome after 6 weeks, 3 and 12 months was documented by different scores.

Results: In all 75 patients, median age 64, the Transtar procedure was performed with 9% intraoperative difficulties, 7% postoperative complications and no mortality. The mean reduction of the ODS score was -15.6 (95%-CI: -17.3 to -13.8, P < 0.0001), mean reduction of SSS was -12.6 (95%-CI: -14.2 to -11.2; P < 0.0001). 41% stated improvement of their continence status by CCF score, only 4 patients (5%) had deterioration.

Conclusion: The Transtar procedure is technically demanding, with good functional results similar to the conventional STARR.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2774156PMC
http://dx.doi.org/10.1111/j.1463-1318.2008.01714.xDOI Listing

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Article Synopsis
  • The study investigates surgical options for obstructed defecation syndrome (ODS) in Italy over a decade, highlighting inconsistencies in functional outcomes from various procedures.
  • Data were collected from 25 referral centers, analyzing 2,943 surgical cases, with focus on techniques suited for different clinical scenarios of ODS based on patients' anal sphincter function.
  • Findings indicate that common surgical methods differ based on sphincter functionality, and there has been a decline in the use of some techniques like STARR and Contour Transtar when sphincter function is poor.
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The evolution of transanal surgery for obstructed defecation syndrome: Mid-term results from a randomized study comparing double TST 36 HV and Contour TRANSTAR staplers.

Am J Surg

November 2018

Ospedale Maggiore Policlinico, Ca' Granda IRCCS Foundation, Milan, Department of Pathophysiology and Transplantation, University of Milan, Via F. Sforza 35 20122 Milan, Italy.

A randomized study was carried out to compare the mid-term outcome of transanal rectal resection with the CCS-30 TRANSTAR and two TST36 staplers in patients with obstructed defecation syndrome. After selection, patients were randomly assigned to 2 groups:104 underwent a TRANSTAR operation and 104 a transanal rectal resection with two TST36 staplers. Patients were followed up with clinical examination, and defecography.

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Perineal stapled rectal resection without a contour transtar: a modified approach.

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Department of Colorectal Surgery, Cleveland Clinic, Digestive Disease Institute, Cleveland, USA.

Perineal stapled prolapse resection is a novel approach for treating rectal prolapse in elderly and frail patients. This study aimed to report a modified technique using only a straight linear stapler. A 94-year-old female with 15-cm full thickness rectal prolapse was treated using a linear cutter in the left and right lateral quadrants, and then resection was completed by using the same instrument in the anterior and posterior flaps.

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Aim: To assess the outcomes of rectal excisional procedures in adults with chronic constipation.

Method: Standardised methods and reporting of benefits and harms were used for all CapaCiTY reviews that closely adhered to PRISMA 2016 guidance. Main conclusions were presented as summary evidence statements with a summative Oxford Centre for Evidence-Based Medicine (2009) level.

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Introduction: Obstructed defecation syndrome (ODS) is a widespread and disabling syndrome. With this study, we want to evaluate the long-term results of stapled transanal rectal resection (STARR) performed with Contour Transtar device in the treatment for ODS. A re-evaluation of 113 patients subjected to STARR from June 2007 to January 2010 was conducted.

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