The Dark Side of Double-Stapled Transanal Rectal Resection

Excerpt

To the Editor— We read with interest the article by Boccasanta et al. 1 that was recently published in the Journal. According to their experience, 96 percent of the patients who underwent double-stapled transanal rectal resection (STARR) for obstructed defecation had good results after one year. The authors did not report any case of pelvic sepsis and rectovaginal fistula. Unfortunately, such complications requiring diverting stoma, and a much higher recurrence rate of constipation, have been reported by others. Excruciating anal pain, fecal incontinence, and massive bleeding also have been described; depression, anxiety, and anismus, i.e., nonrelaxing puborectalis on straining, are the most frequent causes of recurrent constipation.2,3 …