Isbert C
Klinik & Allgemein-, Viszeral- und koloproktologische Chirurgie, Ev. Amalie Sieveking-Krankenhaus, Haselkamp 33, 22359, Hamburg, Deutschland.
Chirurg. 2016 Nov;87(11):924-932. doi: 10.1007/s00104-016-0298-7.
The Contour® Transtar™ operation represents a further methodological development of conventional transanal stapled rectal resection (STARR) for the treatment of obstructed defecation syndrome (ODS) and/or full thickness rectal prolapse. In contrast to the conventional STARR technique a specially designed single curved stapler is used with which the rectal wall is incised in a circular fashion and anastomosed. This results in a monoblock resection with almost unlimited extent of resection. In multicenter studies the procedure has generally been shown to be effective for treatment of ODS with intussusception and rectocele. In comparison to conventional STARR the resected tissue samples are larger and the functional effectiveness is comparable. Furthermore, data from prospective randomized trials revealed higher effectiveness in long-term follow-up. With reference to full thickness rectal prolapse, feasibility studies have been performed which showed low morbidity but long-term follow-up studies suggest a high recurrence rate of >40 %.
Contour® Transtar™手术是治疗排便障碍综合征(ODS)和/或全层直肠脱垂的传统经肛门吻合器直肠切除术(STARR)在方法学上的进一步发展。与传统的STARR技术不同,该手术使用一种特殊设计的单弯吻合器,以环形方式切开直肠壁并进行吻合。这导致了一种几乎可以无限制切除范围的整块切除。在多中心研究中,该手术通常被证明对治疗伴有肠套叠和直肠膨出的ODS有效。与传统的STARR相比,切除的组织样本更大,功能效果相当。此外,前瞻性随机试验的数据显示,长期随访中该手术的效果更高。关于全层直肠脱垂,已经进行了可行性研究,结果显示发病率较低,但长期随访研究表明复发率高达40%以上。