What Benefit With a New Stapler Device in the Surgical Treatment of Obstructed Defecation?

What Benefit With a New Stapler Device in the Surgical Treatment of Obstructed Defecation? Two-Year Outcomes From a Randomized Controlled Trial

This randomized study was designed to compare the 2 year clinical and functional results with the STARR procedure using a new curved cutter stapler or the same operation done with 2 traditional circular staplers.

From January to November 2006, 80 women were selected, with clinical examination, constipation score, colonoscopy, anorectal manometry, and perineography and randomly assigned to 2 groups: 40 patients underwent stapled transanal rectal resection with two staplers PPH-01 (Ethicon Endosurgery Inc, Pomezia, Italy) (STARR group) and 40 had the same operation with new, curved multi-fire stapler Contour R Transtar TM (TRANSTAR group). Patients were followed up with clinical examination, constipation score, and perineography.

Inclusion Criteria:

• Rectal prolapse
• Rectocele
• ODS score > 15
• Continence score < 3
• Resting pressure > 40 mm/Hg

Exclusion Criteria:

• Previous anorectal surgery
• Ods score < 15
• Continence score > 3
• Resting pressure < 40
• Concomitant pelvic floor diseases
• Psychiatric diseases
• Absolute contraindications to surgery