Original Article

International Journal of Colorectal Disease

, Volume 23, Issue 10, pp 999-1005

First online:

Stapled trans-anal rectal resection (STARR) by a new dedicated device for the surgical treatment of obstructed defaecation syndrome caused by rectal intussusception and rectocele: early results of a multicenter prospective study

  • Adolfo RenziAffiliated withColorectal Surgery Unit, S. Stefano Hospital Email author 
  • , Pasquale TalentoAffiliated withColorectal Surgery Unit, Gepos Hospital
  • , Cristiano GiardielloAffiliated withColorectal Surgery Unit, S. Maria della Pietà Hospital
  • , Giovanni AngeloneAffiliated withColorectal Surgery Unit, S. Maria della Pietà Hospital
  • , Domenico IzzoAffiliated withColorectal Surgery Unit, S. Stefano Hospital
  • , Giandomenico Di SarnoAffiliated withColorectal Surgery Unit, S. Stefano Hospital

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Background and aim

Obstructed defaecation syndrome (ODS) represents a very common clinical problem. The aim of the this prospective multicenter study was to evaluate the efficacy and safety of stapler trans-anal rectal resection (STARR) performed by a new dedicated device, CCS-30 Contour Transtar, in patients with ODS caused by rectal intussusception (RI) and/or rectocele (RE).

Materials and methods

All the patients who underwent STARR for ODS caused by RI and/or RE at Colorectal Surgery Units of S. Stefano Hospital, Naples, Gepos Hospital, Telese, Benevento and S. Maria della Pietà Hospital, Casoria, Naples, Italy were prospectively introduced into a database. Preoperatively, all the patients underwent anorectal manometry and cinedefecography. The grade of ODS was assessed using a dedicated obstructed defaecation syndrome score (ODS-S). All the patients with a ODS-S ≥12 and RI and/or RE were enrolled. Patients were followed up clinically at 6 months.


Thirty patients, 28 (93.3%) women, mean age 56.6 ± 12.7 years, underwent STARR, by Transtar, between February and October 2006. Preoperatively, ODS-S was 15.8 ± 2.4. RI was present in 26 (89.6%) and RE (34.4 ± 15.2 mm) in 27 (93.1%) patients. No major postoperative complications occurred. The length of hospital stay was 2.5 ± 0.6 days. At 6-month follow-up, ODS-S was 5.0 ± 2.3 (P < 0.001). Successful outcome was achieved in 25 (86.2%) patients.


STARR, performed by the new dedicated device, CCS-30 Contour Transtar, seems to be an effective and safe procedure to treat ODS caused by RE and/or RI. A longer follow-up and a larger number of patients is needed to confirm these results.


Rectocele Rectal intussusception Rectal prolapse STARR Obstructed defaecation score