Early complications after stapled transanal rectal resection performed using the Contour® Transtar™ device.
OBJECTIVE
This study evaluated the early results (with particular reference to complications) of stapled transanal rectal resection (STARR) carried out using the CCS-30 Contour® Transtar™ device. The procedure was performed in a single centre on patients with obstucted defecation caused by rectocele or rectal intussusception.


METHODS
From July 2007 to February 2009, 133 patients were treated. Preoperatively, all underwent clinical examination, transanal ultrasonography, anorectal manometry and cinedefaecography. Obstructed defaecation syndrome was assessed using the Cleveland Clinic Constipation Score (CCC-S). Early postoperative complications and those occurring within 6 months were recorded.


RESULTS
The median follow-up period was 19 (range 12-30) months. The mean ± standard deviation preoperative CCC-S of 19.4 ± 7.1 decreased to 10.1 ± 9.0 postoperatively. The early complication rate was 15.7% and included rectovaginal fistula (n = 1), rectal perforation (n = 1), posterior dehiscence (n = 4), further surgery for retained staples (n = 2), postoperative bleeding (n = 2) and postoperative impaired continence (n = 11).


CONCLUSIONS
STARR using the Contour Transtar device seems to be effective for treating obstructed defaecation. However, serious complications may occur.
Martellucci
J
J
General Surgery I, University of Siena, Siena, Italy. Jamjac64@hotmail.com
Talento
P
P
Carriero
A
A
D003248:Constipation / Q000209:etiology / Q000601:surgery*; D003672:Defecation; D005260:Female; D006801:Humans; D007443:Intussusception / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D012002:Rectal Diseases / Q000150:complications / Q000601:surgery*; D020047:Rectocele / Q000150:complications / Q000601:surgery; D012720:Severity of Illness Index; D013528:Surgical Staplers / Q000009:adverse effects*; D017792:Surgical Stapling / Q000379:methods*; D013577:Syndrome