Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. May 27, 2021; 13(5): 443-451
Published online May 27, 2021. doi: 10.4240/wjgs.v13.i5.443
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
Jin Meng, Yong Zhang, Xiu Zhao, Qing Zhai, De-Yu Chen, Wei-Gang Yu, Lei Wang, Zhi-Gang Wang, Department of Anorectal Disease, Shenyang Coloproctology Hospital, Shenyang 110000, Liaoning Province, China
Zhi-Tao Yin, Department of Anorectal Disease, Shenyang Hospital of Traditional Chinese Medicine, Shenyang 110000, Liaoning Province, China
Ying-Yi Zhang, First Department of General Surgery, The Third People’s Hospital of Dalian, Dalian 116000, Liaoning Province, China
Author contributions: Wang ZG designed the study; Meng J collected the data and wrote the paper; Zhang YY, Yu WG, and Wang L were responsible for the operation; Zhang Y and Yin ZT conducted follow-up of the cases with anal pressure measurement; Zhai Q and Chen DY conducted anal ultrasound defecography; All authors approved the final manuscript.
Supported by The Natural Science Foundation of Liaoning Province, No. 20170540840.
Institutional review board statement: This study was approved by the Ethics Committee of the Shenyang Coloproctology Hospital, Liaoning Province, China and carried out in accordance with the Helsinki Declaration.
Informed consent statement: All subjects participating in the study signed the informed consent statement form.
Conflict-of-interest statement: There is no conflict of interest issue.
Data sharing statement: Please contact author for data requests.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhi-Gang Wang, MS, Chief Physician, Department of Anorectal Disease, Shenyang Coloproctology Hospital, No. 9 Nanjing North Street, Heping District, Shenyang 110000, Liaoning Province, China. ibenstar@126.com
Received: December 24, 2020
Peer-review started: December 24, 2020
First decision: January 11, 2021
Revised: January 15, 2021
Accepted: April 12, 2021
Article in press: April 12, 2021
Published online: May 27, 2021
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: TST36 stapler, Rectocele, Internal rectal prolapse, Outlet obstructive constipation, Longo obstructed defecation syndrome score, Constipation

Core Tip: Clinical observations were carried out in 49 female patients with rectocele and internal rectal prolapse who met the inclusion criteria and underwent surgery with the TST36 stapler. The postoperative obstructed defecation syndrome score, defecation frequency score, time/straining intensity, and sensation of incomplete evacuation were significantly lower than those before treatment. The initial and maximum defecation thresholds in patients after surgery were significantly lower than those before treatment. The patients’ postoperative ratings of rectocele, resting phase, and defecation phase were significantly decreased compared with those before treatment.