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Sigmoid volvulus: is it a possible complication after stapled transanal rectal resection (STARR)?
Il Giornale Di Chirurgia
|October 5, 2013
Summary
Stapled transanal rectal resection (STARR) may cause sigmoid volvulus, a serious complication, in patients with obstructed defecation syndrome and dolichosigma. This case highlights a rare but severe outcome following the STARR procedure.
Area of Science:
- Gastroenterology
- Colorectal Surgery
Background:
- Obstructed defecation syndrome (ODS) is often associated with anatomical abnormalities like dolichosigma.
- Stapled transanal rectal resection (STARR) is a surgical option for ODS.
- Sigmoid volvulus is a rare but life-threatening complication.
Observation:
- A 68-year-old woman with chronic constipation and dolichosigma underwent STARR procedure.
- Two days post-operatively, she developed severe abdominal pain.
- Computed tomography (CT) confirmed sigmoid ischemia.
Findings:
- The patient required sigmoid colon resection and end colostomy (Hartmann's procedure) due to ischemia.
- This case suggests a potential link between STARR and sigmoid volvulus in susceptible patients.
Implications:
- The STARR procedure may pose a risk of sigmoid volvulus in patients with pre-existing dolichosigma and ODS.
- Further investigation is warranted to understand this complication and optimize patient selection for STARR.
- This finding emphasizes the importance of careful pre-operative assessment and post-operative monitoring.
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