Purpose: This prospective study was designed to assess the efficacy and safety of a novel technique in treating outlet obstruction syndrome using a transanal double-stapling procedure.
Methods: Two hundred thirty patients (187 female) with obstructed defecation underwent stapled transanal rectal resection over a six-year period with follow-up at 2, 6, and 12 months, then yearly; median follow-up was 24 (range, 12-68) months. All failed conservative measures. Patients with slow transit constipation and puborectalis dyssynergia were excluded.
Results: Operating time was short (median, 35 (range, 20-95) minutes), with 159 (69%) performed as day cases (outpatient). Major complications were seen in 16 (7%); there were no deaths. Twelve (5%) patients reported severe postoperative pain. Immediate postoperative fecal urgency was reported by 107 (46%) patients, but persisted at six months in only 26 (11%). Three (1%) developed recurrent rectal prolapse. Nearly all incontinent patients (98%) reported an improvement, with a median Wexner score reduction of 5 points (P < 0.0001). Constipation improved in 77% of patients. Seventy-seven percent of patients were "very glad" they had the operation, and 86% "recommended" stapled transanal rectal resection to a friend.
Conclusion: Stapled transanal rectal resection can be performed on a day-case basis with high levels of patient satisfaction. Incontinence and constipation are improved. However, significant morbidity occurs in 7% of patients, and urgency of defecation persists beyond six months in 11%.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/DCR.0b013e3181b550bf | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
The efficacy of open transanal drainage tube against anastomotic leakage in left-sided colorectal cancer surgery: a propensity score matching study.
BMC Surg
January 2025
Department of Gastroenterological Surgery, Osaka Metropolitan University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-Ku, Osaka, 545-8585, Japan.
Background/aim: The effectiveness of a transanal drainage tube (TAT) for the prevention of anastomotic leakage after double stapling technique (DST) anastomosis in colorectal cancer has been reported. Previously, TATs had been placed and connected to drainage bags. It was considered that a higher decompression effect could be expected by inserting an open-type TAT, without connection to a drainage bag.
View Article and Find Full Text PDFNew alternative colorectal anastomotic devices: A systematic review and meta-analysis.
Am J Surg
December 2024
Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland Clinic Florida, Weston, FL, USA.
Article Synopsis
- Colorectal anastomotic devices have been used for almost 100 years, with stapled methods being most common, despite a significant leak risk of up to 20%.
- A systematic review and meta-analysis explored newer anastomotic devices, analyzing 18 studies from the last decade, which included 955 anastomoses and focused on non-stapled methods.
- The findings indicated a pooled complication rate of 9.7% for human studies, but new compression mechanisms showed a much lower leak rate of 3.3%, suggesting that these novel technologies could improve surgical outcomes.
A novel application of transanal transection and single-stapled anastomosis in salvage surgery for recurrent low rectal cancer following recent laparoscopic anterior resection: A video vignette.
Colorectal Dis
November 2024
AST Ascoli Piceno, San Benedetto del Tronto Madonna Del Soccorso Hospital, San Benedetto del Tronto, 63074, Ascoli Piceno, Italy.
The Effect of Multifaceted Anastomotic Leakage Prevention ICG and SST for Lower Rectal Anastomosis.
In Vivo
October 2024
Department of Digestive Surgery, Kawaguchi Municipal Medical Center, Kawaguchi, Japan.
Background/aim: In rectal cancer surgery, anastomotic leakage (AL) is the most important complication and has a reported frequency of 11-15%. The causes of AL leakage are complex, and AL prevention should be performed in multiple directions. Thus, this study examined the usefulness of the comprehensive and multifaceted AL preventive measures.
View Article and Find Full Text PDFEnhanced transanal surgery training through a 4K 3D surgical exoscope: a novel approach for transanal surgery.
Int J Colorectal Dis
October 2024
Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072, Pieve Emanuele, Milan, Italy.
Article Synopsis
- The exoscope, a more ergonomic alternative to traditional microscopes, is being explored in general surgery, specifically for transanal procedures like ileal-pouch anal anastomosis.
- Surgeons performed a transanal procedure using the ORBEYE™ exoscope system, which provided a high-resolution, 3D view on a large screen, enhancing their ability to operate while keeping a comfortable position.
- The results indicate that the exoscope offered excellent visualization and could improve surgical training by allowing trainees to see techniques clearly, suggesting its potential as a valuable tool in colorectal surgery.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!