Document Detail

Postoperative complications after procedure for prolapsed hemorrhoids (PPH) and stapled transanal rectal resection (STARR) procedures.
MedLine Citation:
PMID:  18512007     Owner:  NLM     Status:  MEDLINE    
Procedure for prolapsing hemorrhoids (PPH) and stapled transanal rectal resection for obstructed defecation (STARR) carry low postoperative pain, but may be followed by unusual and severe postoperative complications. This review deals with the pathogenesis, prevention and treatment of adverse events that may occasionally be life threatening. PPH and STARR carry the expected morbidity following anorectal surgery, such as bleeding, strictures and fecal incontinence. Complications that are particular to these stapled procedures are rectovaginal fistula, chronic proctalgia, total rectal obliteration, rectal wall hematoma and perforation with pelvic sepsis often requiring a diverting stoma. A higher complication rate and worse results are expected after PPH for fourth-degree piles. Enterocele and anismus are contraindications to PPH and STARR and both operations should be used with caution in patients with weak sphincters. In conclusion, complications after PPH and STARR are not infrequent and may be difficult to manage. However, if performed in selected cases by skilled specialists aware of the risks and associated diseases, some complications may be prevented.
M Pescatori; G Gagliardi
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Publication Detail:
Type:  Journal Article; Review     Date:  2008-05-30
Journal Detail:
Title:  Techniques in coloproctology     Volume:  12     ISSN:  1123-6337     ISO Abbreviation:  Tech Coloproctol     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-05-30     Completed Date:  2008-09-19     Revised Date:  2013-06-05    
Medline Journal Info:
Nlm Unique ID:  9613614     Medline TA:  Tech Coloproctol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  7-19     Citation Subset:  IM    
Coloproctology Unit, Ars Medica Hospital, Rome, Italy.
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MeSH Terms
Anal Canal / surgery*
Digestive System Surgical Procedures / methods*
Hemorrhoids / complications,  surgery*
Postoperative Complications*
Rectal Prolapse / complications,  surgery*
Surgical Stapling*
Comment In:
Tech Coloproctol. 2008 Jun;12(2):135-6   [PMID:  18545877 ]
Tech Coloproctol. 2008 Jun;12(2):136-7; author reply 137-8   [PMID:  18700245 ]

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