Conversion in transanal stapling techniques for haemorrhoids and anorectal prolapse

Area of Science:

• Colorectal Surgery
• Minimally Invasive Procedures

Background:

• Transanal stapling techniques are increasingly used for hemorrhoidal disease and internal rectal prolapse.
• Assessing conversion rates and predictors is crucial for surgical planning and patient counseling.

Purpose of the Study:

• To evaluate the role and outcomes of conversion from transanal stapling to traditional techniques.
• To identify potential factors predicting conversion in stapled anorectal surgery.

Main Methods:

• Prospective data collection of patients undergoing planned stapled transanal surgery.
• Definition of 'conversion' as an unplanned switch to a non-stapled technique.
• Logistic regression analysis to identify risk factors for conversion.

Main Results:

• A 95.4% completion rate for stapled procedures (hemorrhoidopexy, mucosectomy, STARR) was achieved in 258 patients.
• A 4.6% conversion rate (12 patients) to conventional surgery was observed.
• Reasons for conversion included anatomical factors, intraoperative findings, and technical difficulties; no specific predictive factors were identified.

Conclusions:

• Transanal stapling is effective for hemorrhoids and rectal prolapse when strict selection criteria are met.
• A 4.6% conversion rate necessitates surgeon proficiency in conventional anorectal procedures.
• Informed consent must address the possibility of conversion to traditional surgery.