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Iatrogenic rectal diverticulum in patients treated with transanal stapled techniques
M E Alabiso1, R Grassi, C Fioroni
1UOC di Radiologia, PO Cardinale Ascalesi - ASL Na 1, Via Egiziaca a Forcella 32, Napoli, Italy. malabiso@inwind.it
La Radiologia Medica
|July 12, 2008
Summary
Rectal diverticula can develop after stapled hemorrhoidectomy (Longo) or STARR procedures. These pouches form at the surgical suture site, potentially causing complications like pain and fecal stasis.
Area of Science:
- Gastroenterology
- Colorectal Surgery
- Medical Imaging
Background:
- Hemorrhoid treatment and obstructed defecation syndrome are common indications for surgical intervention.
- Stapled techniques, including the Longo procedure and STARR, are widely used for these conditions.
Purpose of the Study:
- To investigate the potential for rectal diverticula formation following stapled hemorrhoidectomy (Longo) and stapled transanal rectal resection (STARR).
Main Methods:
- Defecographic examinations were performed on 634 patients, with 45 being postoperative follow-ups for Longo (13) or STARR (32) procedures.
- Analysis focused on identifying rectal diverticula in patients who had undergone these stapled rectal surgeries.
Main Results:
- Seven out of 45 patients (15.5%) developed rectal diverticula post-surgery.
- Diverticula originated from the surgical suture line in all cases.
- One patient experienced acute pain due to fecal stasis in a diverticulum.
Conclusions:
- Endorectal stapling devices can create focal weakness in the rectal wall at the suture site.
- This weakness predisposes patients to developing rectal diverticula after Longo or STARR procedures.
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