Therapeutic effects of the TST36 stapler on rectocele combined with internal rectal prolapse

Jin Meng; Zhi-Tao Yin; Ying-Yi Zhang; Yong Zhang; Xiu Zhao; Qing Zhai; De-Yu Chen; Wei-Gang Yu; Lei Wang; Zhi-Gang Wang

doi:10.4240/wjgs.v13.i5.443

Therapeutic effects of the TST36 stapler on rectocele combined with internal rectal prolapse

World J Gastrointest Surg. 2021 May 27;13(5):443-451. doi: 10.4240/wjgs.v13.i5.443.

Authors

Jin Meng¹, Zhi-Tao Yin², Ying-Yi Zhang³, Yong Zhang¹, Xiu Zhao¹, Qing Zhai¹, De-Yu Chen¹, Wei-Gang Yu¹, Lei Wang¹, Zhi-Gang Wang⁴

Affiliations

¹ Department of Anorectal Disease, Shenyang Coloproctology Hospital, Shenyang 110000, Liaoning Province, China.
² Department of Anorectal Disease, Shenyang Hospital of Traditional Chinese Medicine, Shenyang 110000, Liaoning Province, China.
³ First Department of General Surgery, The Third People's Hospital of Dalian, Dalian 116000, Liaoning Province, China.
⁴ Department of Anorectal Disease, Shenyang Coloproctology Hospital, Shenyang 110000, Liaoning Province, China. ibenstar@126.com.

Abstract

Background: The most common causes of outlet obstructive constipation (OOC) are rectocele and internal rectal prolapse. The surgical methods for OOC are diverse and difficult, and the postoperative complications and recurrence rate are high, which results in both physical and mental pain in patients. With the continuous deepening of the surgeon's concept of minimally invasive surgery and continuous in-depth research on the mechanism of OOC, the treatment concepts and surgical methods are continuously improved.

Aim: To determine the efficacy of the TST36 stapler in the treatment of rectocele combined with internal rectal prolapse.

Methods: From January 2017 to July 2019, 49 female patients with rectocele and internal rectal prolapse who met the inclusion criteria were selected for treatment using the TST36 stapler.

Results: Forty-five patients were cured, 4 patients improved, and the cure rate was 92%. The postoperative obstructed defecation syndrome score, the defecation frequency score, time/straining intensity, and sensation of incomplete evacuation were significantly decreased compared with these parameters before treatment, and the differences were statistically significant (P < 0.05). The postoperative anal canal resting pressure and maximum squeeze pressure in patients decreased compared with before treatment, and the differences were statistically significant (P < 0.05). The initial and maximum defecation thresholds after surgery were significantly lower than those before treatment, and the differences were statistically significant (P < 0.05). The postoperative ratings of rectocele, resting phase, and defecation phase in these patients were significantly decreased compared with those before treatment, and the differences were statistically significant (P < 0.05).

Conclusion: The TST36 stapler is safe and effective in treating rectocele combined with internal rectal prolapse and is worth promoting in clinical work.

Keywords: Constipation; Internal rectal prolapse; Longo obstructed defecation syndrome score; Outlet obstructive constipation; Rectocele; TST36 stapler.