Technological Improvements for the Treatment of Obstructed Defecation Syndrome

被引：1

作者：

Reboa, Giuliano ^{[1
]}

Gipponi, Marco ^{[2
]}

Caviglia, Angelo ^{[3
]}

Matos, Joana ^{[4
]}

Gallo, Maurizio ^{[5
]}

Ferrari, Daniele ^{[6
]}

机构：

[1] San Camillo Hosp, Dept Gen Surg, Coloproctol Unit, Forte Dei Marmi, Lucca, Italy

[2] IRCCS San Martino IST, Dept Gen Surg, Breast Unit, I-16132 Genoa, Italy

[3] San Camillo Hosp, Coloproctol Unit, Rome, Italy

[4] Adv Ctr Expt Surg CCEA, Vila Do Conde, Portugal

[5] IRCCS San Martino IST, Dept Oncol, I-16132 Genoa, Italy

[6] Univ Rome, Dept Engn, Rome, Italy

来源：

IN VIVO | 2015年 / 29卷 / 01期

关键词：

Obstructed defecation syndrome; STARR; transrectal surgery; TRANSANAL RECTAL RESECTION; OUTLET OBSTRUCTION; SURGICAL-TREATMENT; FOLLOW-UP; ANORECTAL FUNCTION; CONTOUR TRANSTAR; SYNDROME ODS; STARR; INTUSSUSCEPTION; CONSTIPATION;

D O I：

暂无

中图分类号：

R-3 [医学研究方法]; R3 [基础医学];

学科分类号：

1001 ;

摘要：

Background/Aim: Standard stapled transanal rectal resection (STARR) with two PPH-01 (TM) poses some questions regarding the completeness of prolapse resection in patients with obstructed defecation syndrome (ODS) since 20% to 30% of patients have persistent rectocele or rectal intussusception that may impair the physiological recovery of rectal sensitivity. New high-volume (HV) devices, such as CPH34 HV (TM) and CPH36 SMS (TM), allow for wider prolapsectomy to be performed and we herein assessed the possibility and safety of a STARR mono-stapler. Materials and Methods: On May 30th-31st 2011, 13 pigs were selected to undergo standard STARR with two PPH-01 (TM) (n=2) or STARR mono-stapler with one CPH34 HV (TM) (n= 11) at the Experimental Center of Vila do Conde (Portugal); another set of 13 pigs was selected on January 14th-17th 2014 to undergo standard STARR (n=2) or STARR mono-stapler by means of one CPH36 SMS (TM) (n= 11). The length, height, square surface, and volume of resected specimens were intra-operatively assessed. Pigs were monitored for three days before undergoing transrectal sonography and autopsy to check for locoregional complications. Results: CPH36 SMS (TM) STARR mono-stapler achieved 57% higher volume of prolapsectomy compared to Standard STARR (p=0.008); moreover, surface measures of the specimens of CPH36 SMS (TM) STARR mono-stapler were significantly higher (length, p=0.003; height, p=0.004; square surface, p=0.002) compared to CPH34 HV (TM) STARR monostapler, with a 97.8% increase of prolapsectomy (p<0.001). No intra- or early postoperative complications occurred. Transrectal sonography and autopsy detected: two (50%) small intra- parietal and two (50%) extra-rectal haematomata after Standard STARR; five small intraparietal (45.5%) and one (9%) extra-rectal haematoma after CPH34 HV (TM) STARR mono-stapler; three (27.2%) small intraparietal and (27.2%) extra-rectal haematomata after CPH36 SMS (TM) STARR monostapler. Conclusion: CPH36 SMS (TM) STARR mono-stapler is quite feasible both from the technological and safety standpoint; most importantly, the higher volume of prolapsectomy achievable with CPH36 SMS (TM) compared to standard STARR with two PPH-01 (TM) might reduce the risk of residual/recurrent prolapse and further improve the clinical efficacy of the STARR procedure.

引用

页码：45 / 50

页数：6