The evolution of transanal surgery for obstructed defecation syndrome: Mid-term results from a randomized study comparing double TST 36 HV and Contour TRANSTAR staplers

Am J Surg. 2018 Nov;216(5):893-899. doi: 10.1016/j.amjsurg.2018.01.074. Epub 2018 Feb 20.

Abstract

A randomized study was carried out to compare the mid-term outcome of transanal rectal resection with the CCS-30 TRANSTAR and two TST36 staplers in patients with obstructed defecation syndrome. After selection, patients were randomly assigned to 2 groups:104 underwent a TRANSTAR operation and 104 a transanal rectal resection with two TST36 staplers. Patients were followed up with clinical examination, and defecography. Cumulative complication rate was significantly higher in TRANSTAR operation (P = 0.019). All symptoms and defecographic parameters significantly improved (P < 0.001), without differences. Costs were significantly lower with double TST (P = 0.035). Recurrence rates were 6.2% in TRANSTAR group and 11.4% with double TST (P = 0.206). Two circular TST 36 staplers consent to obtain the same clinical and functional results than the CCS-30, with significantly lower complication rate and costs.

Keywords: Curved CCS-30 Transtar stapler; Double circular TST36 stapler; Obstructed defecation.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Colonoscopy
  • Constipation / diagnosis
  • Constipation / physiopathology
  • Constipation / surgery*
  • Defecation / physiology*
  • Defecography
  • Equipment Design
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Manometry
  • Middle Aged
  • Natural Orifice Endoscopic Surgery / methods*
  • Rectum
  • Retrospective Studies
  • Surgical Staplers*
  • Surgical Stapling / instrumentation*
  • Syndrome
  • Time Factors
  • Treatment Outcome