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Stapled Transanal Rectal Resection With Contour Transtar for Obstructed Defecation Syndrome: Lessons Learned After More Than 3 Years of Single-Center Activity

Luigi, Masoni M.D.; Saverio, Mari Francesco M.D.; Francesco, Favi M.D.; Gasparrini, Marcello M.D.; Michele, Cosenza Umile M.D.; Fioralba, Pindozzi M.D.; Alessandra, Pancaldi M.D.; Antonio, Brescia M.D.


In the article appearing on page 113 of the January 2013 issue of Diseases of the Colon & Rectum, the author listing is incorrect.

The correct list of author names is as follows.

Luigi Masoni, M.D. • Francesco Saverio Mari, M.D. • Francesco Favi, M.D.

Marcello Gasparrini, M.D. • Umile Michele Cosenza, M.D. • Fioralba Pindozzi, M.D. • Alessandra Pancaldi, M.D. • Antonio Brescia, M.D.

Diseases of the Colon & Rectum. 56(3):396, March 2013.

Diseases of the Colon & Rectum: January 2013 - Volume 56 - Issue 1 - p 113–119
doi: 10.1097/DCR.0b013e31826bda94
Original Contribution: Pelvic Floor

BACKGROUND: Obstructed defecation syndrome is a widespread and disabling disease.

OBJECTIVE: We aim to evaluate the safety and efficacy of stapled transanal rectal resection performed with a new dedicated curved device in the treatment of obstructed defecation syndrome.

DESIGN: A retrospective review of 187 stapled transanal rectal resections performed from June 2007 to February 2011 was conducted.

SETTINGS: The entire study was conducted at a university hospital.

PATIENTS: All the patients with symptomatic obstructed defecation syndrome and the presence of a rectocele and/or a rectorectal or rectoanal intussusception, in the absence of sphincter contractile deficiency, were included in the treatment protocol.

INTERVENTIONS: All procedures were performed with the use of the Contour Transtar device. We analyzed the functional results of this technique, the incidence and features of the surgical and functional complications, and ways to prevent or treat them.

MAIN OUTCOME MEASURES: Constipation was graded by using the Agachan-Wexner constipation score; use of aids to defecate and patient satisfaction were assessed preoperatively and 6 months after surgery. Intraoperative and postoperative complications were also investigated.

RESULTS: The constipation intensity was statistically reduced from the preoperative mean value of 15.8 (± 4.9) to 5.2 (± 3.9) at 6 months after surgery (p < 0.0001). Of the 151 (80.3%) patients who took laxatives and the 49 (26.2%) who used enemas before treatment, only 25 (13.2%; p < 0.0001) and 7 (3.7%; p < 0.0001) continued to do so after surgery. None of the 17 (9.1%) patients who had previously helped themselves with digitations needed to continue this practice. Almost all patients showed a good satisfaction rate (3.87/5) after the procedure.

LIMITATIONS: Limitations are the short follow-up of 1 year and the design of the study that may introduce potential selection bias.

CONCLUSIONS: The results of this study show that stapled transanal rectal resection performed with the use of the Contour Transtar is a safe and effective procedure to treat obstructed defecation syndrome.

Department of Medical-Surgical Sciences and Translational Medicine, St. Andrea Hospital, School of Medicine and Psychology, University Sapienza of Rome, Rome, Italy

Financial Disclosure: None reported.

Correspondence: Francesco Saverio Mari, St Andrea Hospital, Department of Surgery, Faculty of Medicine and Psychology, University Sapienza of Rome, Via di Grottarossa 1035, 00189 Rome, Italy. E-mail:

© The ASCRS 2013