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

• Published in: The American journal of surgery Vol. 216; no. 5; pp. 893 - 899
• Main Authors: Boccasanta, Paolo, Agradi, Sergio, Vergani, Contardo, Calabrò, Giuseppe, Bordoni, Luca, Missaglia, Claudio, Venturi, Marco
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-11-2018; Elsevier Limited
• Subjects: Analgesics; Curved CCS-30 Transtar stapler; Defecation; Double circular TST36 stapler; Health surveys; Hospitals; Obstructed defecation; Pain; Patient satisfaction; Patients; Randomization; Rectum; Surgery; Italy; Obstructed defecation; Double circular TST36 stapler; Curved CCS-30 Transtar stapler
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2018.01.074

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.
•The curved multi-fire Transtar stapler has higher complication rate than two circular TST 36 staplers.•Mid term result on symptoms and defecography are the same with curved multi-fire and double circular staplers.•Two circular high volume staplers are less expensive than a curved multifire device for the cure of obstructed defecation syndrome.