title: Laparoscopic approach in a case of retroperitoneal and mesorectal haematoma following STARR procedure.
abstract: BACKGROUND
  Stapled transanal rectal resection (STARR) is a widely accepted procedure for treatment of obstructed defecation syndrome.
  
  
  METHODS
  We analyzed major bleeding following STARR and exposed our experience regarding its conservative management with particular attention about diagnostic and therapeutic aspects.
  
  
  CONCLUSIONS
  A case by case discussion should be carried out and treatments should be driven by the features and the progression of the haematoma with regards to size, inflammatory signs or severe rectal obstruction.
  
  
  CONCLUSIONS
  If a second surgical time and exploration is considered, laparoscopy should be an effective choice while laparotomy, stoma or rectal resection should be considered in those cases with strong suspicious of peritonitis and pelvic abscess.
authors.affiliation: General and Mininvasive Surgery - Policlinic of Abano Terme, Italy; Second Unit of General Surgery - "Santa Maria degli Angeli" Hospital of Pordenone, Italy. Electronic address: drcerullo@tiscali.it.
authors.forename: Guido
authors.initials: G
authors.lastname: Cerullo
authors.affiliation: General and Mininvasive Surgery - Policlinic of Abano Terme, Italy.
authors.forename: Diletta
authors.initials: D
authors.lastname: Cassini
authors.affiliation: General, Emergency and Minimally Invasive Surgery - Careggi University Hospital of Florence, Italy.
authors.forename: Jacopo
authors.initials: J
authors.lastname: Martellucci
authors.affiliation: General and Mininvasive Surgery - Policlinic of Abano Terme, Italy.
authors.forename: Gianandrea
authors.initials: G
authors.lastname: Baldazzi
keywords: Major bleeding; Obstructed defecation syndrome; STARR