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Stapled transanal rectal resection for outlet obstruction: a prospective, multicenter trial
Paolo Boccasanta1, Marco Venturi, Angelo Stuto
1Ospedale Maggiore di Milano I.R.C.C.S., University of Milan, Milan, Italy. pboccasanta@tiscali.it
Diseases of the Colon and Rectum
|October 16, 2004
Summary
A new stapler technique effectively treated outlet obstruction from intussusception and rectocele, improving constipation without affecting continence. This safe and effective method showed excellent or good outcomes in most patients after one year.
Area of Science:
- Colorectal Surgery
- Gastroenterology
- Surgical Innovation
Background:
- Outlet obstruction is a common cause of constipation.
- Intussusception and rectocele often coexist, complicating treatment.
- Novel surgical techniques are needed to address complex outlet obstruction.
Purpose of the Study:
- To evaluate the safety and efficacy of a double-transanal circular stapler technique.
- To treat outlet obstruction caused by combined intussusception and rectocele.
Main Methods:
- Prospective, multicenter trial of 90 patients.
- Follow-up using validated scoring systems, clinical exams, defecography, and manometry.
- Anal ultrasound in 58 multiparous patients.
Main Results:
- Short operative time, minimal pain, and quick return to normal activity.
- Significant improvement in constipation symptoms (P < 0.001) with no worsening of continence.
- Successful correction of intussusception and rectocele confirmed by defecography; rectal compliance restored (P < 0.05).
Conclusions:
- The double-transanal stapler technique is a safe and effective treatment for outlet obstruction due to intussusception and rectocele.
- The procedure demonstrated favorable short-term outcomes and anatomical correction.
- Further randomized trials are recommended to validate these findings.