scholarly journals TRREMS procedure (transanal repair of rectocele and rectal mucosectomy with one circular stapler): a prospective multicenter trial

2011 ◽  
Vol 48 (1) ◽  
pp. 3-7 ◽  
Author(s):  
José Vinicius Cruz ◽  
Francisco Sergio P. Regadas ◽  
Sthela Maria Murad-Regadas ◽  
Lusmar Veras Rodrigues ◽  
Fernando Benicio ◽  
...  
Keyword(s):  
Obstructed Defecation ◽  
Circular Stapler ◽  
Multicenter Trial ◽  
Colonic Transit ◽  
Rectal Intussusception ◽  
Rectal Pain ◽  
Transanal Repair ◽  
Rectal Mucosectomy ◽  
The Mean ◽  
Prospective Multicenter Trial

CONTEXT: Since anorectocele is usually associated with mucosa prolapse and/or rectal intussusceptions, it was developed a stapled surgical technique using one circular stapler. OBJECTIVE: To report the results of Transanal Repair of Rectocele and Rectal Mucosectomy with one Circular Stapler (TRREMS procedure) in the treatment of anorectocele with mucosa prolapse in a prospective multicenter trial. METHODS: It was conducted by 14 surgeons and included 75 female patients, mean aged 49.6 years, with symptoms of obstructed defecation due to grade 2 (26.7%) and grade 3 (73.3%) anorectocele associated with mucosa prolapse and/or rectal intussusception (52.0%) and an average validated Wexner constipation score of 16. All patients were evaluated by a proctological examination, cinedefecography, anal manometry and colonic transit time. The TRREMS procedure consists of the manual removal of the rectocele wall with circumferential rectal mucosectomy performed with a circular stapler. The mean follow-up time was 21 months. RESULTS: All patients presented obstructed defecation and they persisted with symptoms despite conservative treatment. The mean operative time was 42 minutes. In 13 (17.3%) patients, bleeding from the stapled line required hemostatic suture. Stapling was incomplete in 2 (2.6%). Forty-nine patients (65.3%) required 1 hospitalization day, the remainder (34.7%) 2 days. Postoperatively, 3 (4.0%) patients complained of persistent rectal pain and 7 (9.3%) developed stricture on the stapled suture subsequently treated by stricturectomy under anesthesia (n = 1), endoscopic stricturectomy with hot biopsy forceps (n = 3) and digital dilatation (n = 3). Postoperative cinedefecography showed residual grade I anorectoceles in 8 (10.6%). The mean Wexner constipation score decreased significantly from 16 to 4 (0-4: n = 68) (6: n = 6) (7: n = 1) (P<0.0001). CONCLUSION: Current trial results suggest that TRREMS procedure is a safe and effective technique for the treatment of anorectocele associated with mucosa prolapse. The stapling technique is low-cost as requires the use of a single circular stapler.

scholarly journals Stapled Transanal Rectal Resection for the Surgical Treatment of Obstructed Defecation Syndrome Associated with Rectocele and Rectal Intussusception

ISRN Surgery ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Hesham M. Hasan ◽  
Hani M. Hasan
Keyword(s):  
Surgical Technique ◽  
Rectal Resection ◽  
Obstructed Defecation ◽  
Circular Stapler ◽  
Rectal Intussusception ◽  
Prospective Clinical Study ◽  
Safe Procedure ◽  
Stapled Transanal Rectal Resection ◽  
Obstructed Defecation Syndrome

Obstructed defecation syndrome (ODS) is one of the most widespread clinical problems which frequently affects middle-aged females. There is a new surgical technique called stapled transanal rectal resection (STARR) that makes it possible to remove the anorectal mucosa circumferential and reinforce the anterior anorectal junction wall with the use of a circular stapler. This surgical technique developed by Antonio Longo was proposed as an effective alternative for the treatment of ODS. In this study we present our preliminary results with the STARR operation for the treatment of ODS. For this purpose, 40 consecutive female patients with ODS due to rectal intussusception (RI) and/or rectocele (RE) were recruited in this prospective clinical study, from May 2008 to October 2010. No major operative or postoperative complications were recorded, and after 12-month follow-up, significant improvement in the ODS score system was observed, and the symptoms of constipation improved in 90% of patients; 20% of patients judged their final clinical outcome as excellent, 55% as good, and 15% as moderate, with only 10% having poor results. After analyzing our results we can conclude that STARR is an effective and safe procedure for the treatment of obstructed defecation syndrome due to rectal intussusception and/or rectocele and can be performed safely without major morbidity.

Transanal repair of rectocele and full rectal mucosectomy with one circular stapler: a novel surgical technique

2005 ◽  
Vol 9 (1) ◽  
pp. 63-66 ◽  
Author(s):  
F. S. P. Regadas ◽  
S. M. M. Regadas ◽  
L. V. Rodrigues ◽  
R. Misici ◽  
F. R. Silva ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Circular Stapler ◽  
Transanal Repair ◽  
Rectal Mucosectomy

Prospective Multicenter Trial Comparing Echodefecography With Defecography in the Assessment of Anorectal Dysfunction in Patients With Obstructed Defecation

2011 ◽  
Vol 54 (6) ◽  
pp. 686-692 ◽  
Author(s):  
F. Sergio P. Regadas ◽  
Eric M. Haas ◽  
Maher A. Abbas ◽  
J. Marcio Jorge ◽  
Angelita Habr-Gama ◽  
...  
Keyword(s):  
Obstructed Defecation ◽  
Multicenter Trial ◽  
Anorectal Dysfunction ◽  
Prospective Multicenter Trial

103: Minimal Invasive Treatment of Men with Cathegory IIIB (CPPS) Prostatitis. A Prospective Multicenter Trial: Results of the MICP Study

2007 ◽  
Vol 177 (4S) ◽  
pp. 36-36
Author(s):  
Bob Djavan ◽  
Christian Seitz ◽  
Martina Nowak ◽  
Michael Dobrovits ◽  
Mike Harik ◽  
...  
Keyword(s):  
Multicenter Trial ◽  
Minimal Invasive ◽  
Invasive Treatment ◽  
Minimal Invasive Treatment ◽  
Prospective Multicenter Trial

Endovenous radiofrequency powered segmental thermal ablation (Closure FAST) of great saphenous veins

Phlebologie ◽  
2010 ◽  
Vol 39 (02) ◽  
pp. 69-71 ◽  
Author(s):  
T. M. Proebstle ◽  
Keyword(s):  
Side Effects ◽  
Thermal Ablation ◽  
Clinical Success ◽  
Clinical Success Rate ◽  
Duplex Ultrasound ◽  
Multicenter Trial ◽  
Saphenous Veins ◽  
Clinical Control ◽  
Prospective Multicenter Trial

Summary Background: Radiofrequency powered segmental thermal ablation Closure FAST has become a globally engaged technology for ablation of incompetent great saphenous veins (GSVs). Mid-term results of slowly resolving side effects are still not described. Methods: RSTA-treated GSVs (n = 295) were followed for 24 months in a prospective multicenter trial. Clinical control visits included flow and reflux analysis by duplex-ultrasound and assessment of treatment related side effects at all times. Results: 280 of 295 treated GSVs (94.9%) were available for 24 months follow-up. According to the method of Kaplan and Meier at 24 months after the intervention 98.6% of treated legs remained free of clinically relevant axial reflux. The average VCSS score improved from 3.9 ± 2.1 at screening to 0.7 ± 1.2 at 24 months follow-up (p < 0.0001). While only 41.1% of patients were free of pain before treatment, at 24 months 99.3% reported no pain and 96.4% did not experience pain during the 12 months before. At 24 months n=3 legs showed pigmentation along the inner thigh and one leg showed study-treatment related paresthesia. Conclusion: Radiofrequency powered segmental thermal ablation Closure FAST showed a very moderate side-effect profile in conjunction with a high and durable clinical success rate.

Sign in / Sign up

Export Citation Format

Share Document