title: Serious unconventional complications of surgery with stapler for haemorrhoidal prolapse and obstructed defaecation because of rectocoele and rectal intussusception.
abstract: OBJECTIVE
  Treatment of haemorrhoidal prolapse by stapled haemorrhoidopexy (SH) and obstructed defaecation syndrome with the stapled transanal rectal resection (STARR) technique is becoming increasingly popular with patients and surgeons. Unfortunately, serious complications have been identified. The aim of the present study was to analyse the complications and their treatment to see where they might be avoided and to determine best management.
  
  
  METHODS
  All Units of Coloproctology belonging to the Italian Unitary Society of Coloproctology (SIUCP) were asked to return documentation of serious complications following SH and STARR.
  
  
  RESULTS
  Forty-six reports were received from 23 centres. Twenty-seven serious complications were reported. Twenty occurred after SH (13 PPH 03, 7 PPH 01) (Endo-surgery Inc., Cincinnati, Ohio, USA) and seven after STARR. Complications were treated by abdominal operation in nine patients [colostomy (3), ileostomy (2), Hartmann's resection (1) and anterior resection (1)].
  
  
  CONCLUSIONS
  Stapled haemorrhoidopexy and STARR can result in serious complications requiring major surgery for their treatment.
authors.affiliation: Department of General Surgery IV, Santa Chiara Hospital, Pisa, Italy. g.naldini@ao-pisa.toscana.it
authors.forename: G
authors.initials: G
authors.lastname: Naldini
mesh_terms: D003248:Constipation / Q000209:etiology / Q000601:surgery; D003672:Defecation; D013505:Digestive System Surgical Procedures / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006406:Hematoma / Q000209:etiology; D006484:Hemorrhoids / Q000601:surgery*; D006801:Humans; D007443:Intussusception / Q000150:complications / Q000601:surgery*; D007558:Italy; D009336:Necrosis / Q000209:etiology; D011391:Prolapse; D012002:Rectal Diseases / Q000150:complications / Q000601:surgery*; D020047:Rectocele / Q000150:complications / Q000601:surgery*; D012006:Rectovaginal Fistula / Q000209:etiology; D018805:Sepsis / Q000209:etiology; D017792:Surgical Stapling / Q000009:adverse effects* / Q000379:methods; D013529:Surgical Wound Dehiscence / Q000209:etiology