Circular Stapling Procedure for Mucosal Prolapse of the Rectum Associated with Outlet Obstruction.

Abstract

Summary: The aim of this study was designed to investigate the outcome from using the new circular stapling device in the surgical treatment for mucosal prolapse of the rectum associated with outlet obstruction. The treatment consisted of resection of the mucosal prolapse through a transverse incision and resecting a suitable part of the mucosa between the rectum and the anal canal, using an HCS33 circular stapler. Eleven patients successfully underwent this operation without morbidity or mortality, and were assessed clinically and by rectoanal manometry and defecography pre-and post-operation. The mean operating time was 39 (range 22-49) min. The postoperative proctalgia and complications were mild, and the patients were discharged at 4 days after the operation. The pre-operative constipation was improved, and the patient's satisfaction was increased at one month after operation in comparison with the preoperative level. Rectoanal function test at 6 months after the operation demonstrated normalization of the maximum resting and squeezing pressures of the anal canal and rectal compliance to the normal levels. No patient has had recurrence of symptoms during the follow-up period. Our data suggest that this procedure may be a useful surgical treatment, as it causes little postoperative complication and enables early discharge of the patients. However, long-term outcomes of recurrence, continence, and constipation need to be evaluated in a more extended follow-up.

Stapled transanal rectal resection (STARR): a new option in the treatment of obstructive defecation syndrome

“…The transanal procedures with mucosal resection (Delorme's technique) showed success rates ranging from 58 to 75% [8,28,29]. Within an actual study using a circular mucosal stapled resection, Araki et al [9] demonstrated a significant improvement in 11 selected patients.…”

“…In the therapy of symptomatic distal intussusception, procedures range from transanal resection of the mucosa to abdominal rectopexy. No evidence-based therapeutic algorhythm has been defined so far [6][7][8][9].…”

Procedure for Prolapsed Hemorrhoids for Treatment of Rectal Mucosa Prolapse following Anorectoplasty for Imperforate Anus

“…Although not considered a traditional indication, the PPH has also been used for the treatment of rectal mucosal prolapse with outlet obstruction, other functional disorders of defection, and even rectocele. [5][6][7][8] To the best of our knowledge, this is the first report of a PPH used for rectal mucosal prolapse in a patient with a history of a high imperforate anus.…”

Treatment of Rectal Mucosal Prolapse with Radiofrequency Ablation and Plication - A New Surgical Technique

“…This includes the traditional extended hemorrhoiddectomy by ligature and excision of the prolapsing mucosa 3 . More recently, the stapled transanal excision of the prolapse using the Longo's technique has been used with encouraging results 4 .…”