title: Feasibility and safety study of day-case Transtar™ procedure.
abstract: BACKGROUND
  Short hospitalization surgery is cost effective and convenient for both patients and healthcare system. Stapled transanal rectal resection (STARR) conducted with the new curved device, Contour Transtar, has proved an effective and safe procedure for treatment of obstructed defecation syndrome. The aim of this study was to determine the safety and feasibility of STARR, performed as a day-case procedure.
  
  
  METHODS
  Retrospective review was performed of all STARR performed as day-case surgery between September 2009 and February 2011. The entire study (intervention, data collection and data analysis) was conducted at the One-day Surgery Unit of the St. Andrea Hospital, Rome, Italy. All patients with surgical indication to STARR for the presence of an obstructed defecation syndrome were included in the study. We excluded from day-case protocol, patients over 65 years old, with an ASA score of III-IV or with a BMI over 35. The surgical technique reflects the original technique proposed by Antonio Longo with the exception of the longitudinal prolapse opening, which was created with the use of an electric scalpel between two Kocher clamps and not by an application of Transtar stapler. To evaluate the feasibility and safety of performing this procedure with short hospitalization, we investigated the presence and the time of presentation of post-operative complications.
  
  
  RESULTS
  Eighty-nine patients underwent STARR as a day-case regimen, and none presented major complications or required an extension of hospital stay or readmission.
  
  
  CONCLUSIONS
  STARR performed with Contour Transtar, in selected patients, is safe and feasible in day-case regimen if performed by expert surgeons and in a structure that allows the physician to keep the patient hospitalized or to re-admit and promptly treat those patients who present major surgical complication.
authors.affiliation: Department of Medical and Surgical Sciences and Translational Medicine, St. Andrea Hospital, School of Medicine and Psychology, University Sapienza of Rome, Italy. frasavmari@yahoo.it
authors.forename: Francesco Saverio
authors.initials: FS
authors.lastname: Mari
authors.forename: Marcello
authors.initials: M
authors.lastname: Gasparrini
authors.forename: Umile Michele
authors.initials: UM
authors.lastname: Cosenza
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Nigri
authors.forename: Anna
authors.initials: A
authors.lastname: Dall'Oglio
authors.forename: Fioralba
authors.initials: F
authors.lastname: Pindozzi
authors.forename: Giammauro
authors.initials: G
authors.lastname: Berardi
authors.forename: Alessandra
authors.initials: A
authors.lastname: Pancaldi
authors.forename: Antonio
authors.initials: A
authors.lastname: Brescia
mesh_terms: D000328:Adult; D000368:Aged; D000556:Ambulatory Surgical Procedures / Q000379:methods*; D003248:Constipation / Q000503:physiopathology / Q000601:surgery*; D003672:Defecation; D013505:Digestive System Surgical Procedures / Q000379:methods*; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay / Q000639:trends; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013536:Suture Techniques / Q000295:instrumentation*; D013537:Sutures; D016896:Treatment Outcome