Proctalgia in a patient with staples retained in the puborectalis muscle after STARR operation.
Stapled transanal rectal resection (STARR) is a novel surgical technique for the treatment of intussusception and rectocele causing obstructed defecation. In this procedure, a double full-thickness rectal resection is performed transanally using two circular staplers. We describe the case of a patient complaining of persistent pain, tenesmus and fecal urgency after STARR. The patient also had an external rectal prolapse requiring an Altemeier rectosigmoid resection; during this operation we found and removed several staples that had stuck to the puborectalis muscle during STARR. Some degree of muscle inflammation was found at histological analysis. The patient recovered fully after this reintervention. Among the complications reported after STARR, the present one had not previously been described. The retained staples might have caused proctalgia in this patient.
De Nardi
P
P
Department of Surgery, Scientific Institute San Raffaele Hospital, Via Olgettina 60, I-20132 Milan, Italy. denardi.paola@hsr.it
Bottini
C
C
Faticanti Scucchi
L
L
Palazzi
A
A
Pescatori
M
M
D000368:Aged; D003082:Colectomy / Q000009:adverse effects*; D003248:Constipation / Q000150:complications / Q000601:surgery*; D020878:Device Removal; D003937:Diagnosis, Differential; D019160:Endosonography; D005260:Female; D005500:Follow-Up Studies; D005547:Foreign Bodies / Q000150:complications / Q000000981:diagnostic imaging; D006801:Humans; D007443:Intussusception / Q000150:complications / Q000601:surgery*; D018482:Muscle, Skeletal; D010146:Pain / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D020047:Rectocele / Q000150:complications / Q000601:surgery*; D012086:Reoperation; D013536:Suture Techniques / Q000009:adverse effects / Q000295:instrumentation*; D013537:Sutures / Q000009:adverse effects*