Tailored prolapse surgery for the treatment of haemorrhoids and obstructed defecation syndrome with a new dedicated device: TST STARR Plus
Tailored prolapse surgery for the treatment of haemorrhoids and obstructed defecation syndrome with a new dedicated device: TST STARR Plus
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DOI：
10.1007/s00384-014-1845-7
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发表时间：
2014-05-01
影响因子：
2.8
通讯作者：
Mascagni, Domenico
中科院分区：
文献类型：
--
作者：
Naldini, Gabriele;Martellucci, Jacopo;Mascagni, Domenico
本研究旨在评估使用新型专用器械TST STARR Plus进行吻合器经肛门手术的安全性、有效性和可行性，所有连续入住8个转诊中心的患者，均患有III-IV度痔脱垂或排便障碍综合征（ODS）伴直肠前突和/或或直肠肠套叠，并使用TST STARR plus进行吻合器经肛门切除术。从2012年11月1日至2013年3月31日，连续160例患者（96例女性）入组本研究，记录缝合线出血的止血缝线、标本体积、手术时间、住院时间和围手术期并发症。94例患者脱垂超过环形肛门扩张器（CAD）的一半。平均手术时间为25分钟，平均切除标本体积为13.3 cm（3），平均住院时间为2.2天。88例患者（55%）需要在缝合线上额外缝合（平均2.1针）。4例病例报告缝线裂开，术中加固。7例患者（5%）报告出血。1例患者报告30天后出现尿急。无严重并发症发生。新装置似乎是安全和有效的一个定制的方法肛门直肠脱垂由于痔疮或排便阻塞。
The aim of the study was to assess the safety, efficacy and feasibility of stapled transanal procedures performed by a new dedicated device, TST STARR Plus, for tailored transanal stapled surgery.All the consecutive patients admitted to eight referral centres affected by prolapses with III-IV degrees haemorrhoids or obstructed defecation syndrome (ODS) with rectocele and/or rectal intussusception that underwent stapled transanal resection with TST STARR plus were included in the present study. Haemostatic stitches for bleeding of the suture line, specimen volume, operative time, hospital stay and perioperative complications were recorded.From 1 November 2012 to 31 March 2013, 160 consecutive patients (96 females) were enrolled in the study. In 94 patients, the prolapse was over the half of the circular anal dilator (CAD). The mean duration of the procedure was 25 min. The mean resected volume of the specimen was 13.3 cm(3), the mean hospital stay was 2.2 days. In 88 patients (55 %), additional stitches on the suture line were needed (mean 2.1). Suture line dehiscence was reported in four cases, with intraoperative reinforcement. Bleeding was reported in seven patients (5 %). Urgency after 30 days was reported in one patient. No major complication occurred.The new device seems to be safe and effective for a tailored approach to anorectal prolapse due to haemorrhoids or obstructed defecation.