Agraffectomy after low rectal stapling procedures for hemorrhoids and rectocele.

Area of Science:

• Colorectal surgery
• Gastroenterology
• Surgical complications

Background:

• Persistent issues after stapled hemorrhoidopexy (SHP) or rectocele stapling may require reintervention.
• Agraffectomy, the removal of retained staples, is a potential treatment for these complications.
• This procedure can range from simple staple removal to excising the entire staple line and scar tissue.

Purpose of the Study:

• To review the published literature on agraffectomy following low rectal stapling.
• To evaluate the indications and outcomes of agraffectomy for complications after SHP and rectocele stapling.

Main Methods:

• A systematic literature search was conducted on Medline, Pubmed, and Embase.
• Search terms included various variations of "agraffectomy".

Main Results:

• Fourteen reports on agraffectomy for complications after rectal stapling were identified.
• Agraffectomy is rarely reported for SHP complications.
• It appears reasonable for rectal stenosis, complete occlusion, rectal bleeding, or to prevent penile injury.
• Low-level evidence suggests limited relief for incontinence or chronic pain.

Conclusions:

• Agraffectomy is indicated for rectal stenosis and staple-induced hemorrhage.
• There is insufficient evidence to support agraffectomy for other complications like incontinence or chronic pain.