Abstract
Purpose
Contour® Transtar™ procedure for rectal prolapse is a promising technique according to safety and efficacy. One potential surgical problem is failure of the stapler due to the thick rectal wall. In order to evaluate the practicability and the impending limitations of the Contour® Transtar™ technique, we reviewed our data with special respect to the necessity of additional anastomosis suturing.
Methods
A prospective analysis of 25 consecutive patients, which underwent Contour® Transtar™ procedure from January 2009 to July 2012, was performed. For statistic analysis, the groups with and without additional suturing of the anastomosis were evaluated according to patient characteristics and surgical outcome.
Results
Twenty-five patients, three men and 22 women, underwent transanal Contour® Transtar™ stapling procedure for rectal prolapse. Due to stapling failure, additional suturing of the anastomosis was necessary in 4 of 25 procedures (16 %). Age (74.1 vs. 83.1 years) and body mass index (30.8 vs. 22.7 kg/m2) were significantly different with and without additional suturing. Operative time was longer (62 vs. 31 min), more cartridges were used (12 vs. 6), and the specimen weight was higher (220 vs. 107 g) in patients with additional suturing. Early postoperative complications were observed in two patients without anastomosis suturing including one patient with bleeding and systemic inflammatory reaction in one case. Postoperative stay did not differ between both groups.
Conclusion
Patients with extensive obesity, which present with a substantial rectal prolapse, may need additional suturing of the rectal anastomosis after Contour® Transtar™ stapling. This causes prolonged operative time. However, this does not correlate with complications and it is not related to significant longer hospital stay.
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References
Formijne Jonkers HA, Draaisma WA, Wexner SD, Broeders IA, Bemelman WA, Lindsey I, Consten EC (2012) Evaluation and surgical treatment of rectal prolapse: an international survey. Colorectal Dis 15(1):115–119
Varma M, Rafferty J, Buie WD, Standards Practice Task Force of American Society of C, Rectal S (2011) Practice parameters for the management of rectal prolapse. Dis Colon Rectum 54(11):1339–1346
Sailer M, Bonicke L, Petersen S (2007) Surgical options in the treatment of rectal prolapse: indications, techniques and results. Zentralbl Chir 132(4):350–357
Altemeier WA, Culbertson WR, Schowengerdt C, Hunt J (1971) Nineteen years’ experience with the one-stage perineal repair of rectal prolapse. Ann Surg 173(6):993–1006
Romano G, Bianco F, Caggiano L (2009) Modified perineal stapled rectal resection with Contour Transtar for full-thickness rectal prolapse. Colorectal Dis 11(8):878–881
Scherer R, Marti L, Hetzer FH (2008) Perineal stapled prolapse resection: a new procedure for external rectal prolapse. Dis Colon Rectum 51(11):1727–1730
Kim M, Reibetanz J, Boenicke L, Germer CT, Jayne D, Isbert C (2010) Quality of life after transperineal rectosigmoidectomy. Br J Surg 97(2):269–272
Cirocco WC (2010) The Altemeier procedure for rectal prolapse: an operation for all ages. Dis Colon Rectum 53(12):1618–1623
Bennett BH, Geelhoed GW (1985) A stapler modification of the Altemeier procedure for rectal prolapse. Experimental and clinical evaluation. Am Surg 51(2):116–120
Hetzer FH, Roushan AH, Wolf K, Beutner U, Borovicka J, Lange J, Marti L (2010) Functional outcome after perineal stapled prolapse resection for external rectal prolapse. BMC Surg 10(9)
Mistrangelo M, Tonello P, Allaix ME, Borroni R, Canavesio N, Corno F (2012) Perineal stapled prolapse resection for complete external rectal prolapse: preliminary experience and literature review. Dig Surg 29(2):87–91
Russell MM, Read TE, Roberts PL, Hall JF, Marcello PW, Schoetz DJ, Ricciardi R (2012) Complications after rectal prolapse surgery: does approach matter. Dis Colon Rectum 55(4):450–458
Isbert C, Jayne D, Germer CT, Boenicke L (2010) Severe mesorectal bleeding after stapled transanal rectal resection (STARR-operation) using the ‘Contour Transtar Curved Cutter Stapler’. Colorectal Dis 12(5):494
Martellucci J, Talento P, Carriero A (2011) Early complications after stapled transanal rectal resection performed using the Contour(R) Transtar device. Colorectal Dis 13(12):1428–1431
Martellucci J, Talento P, Carriero A (2010) Perineal stapled rectal resection with Contour Transtar. Colorectal Dis 12(3):271–272
Ris F, Colin JF, Chilcott M, Remue C, Jamart J, Kartheuser A (2012) Altemeier’s procedure for rectal prolapse: analysis of long-term outcome in 60 patients. Colorectal Dis 14(9):1106–1111
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Petersen, S., Schinkel, B., Jürgens, S. et al. Impact of prolapse mass on Contour® Transtar™ technique for third-degree rectal prolapse. Int J Colorectal Dis 28, 1027–1030 (2013). https://doi.org/10.1007/s00384-013-1649-1
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DOI: https://doi.org/10.1007/s00384-013-1649-1