Serious unconventional complications of surgery with stapler for haemorrhoidal prolapse and obstructed defaecation because of rectocoele and rectal intussusception.

AIM: Treatment of haemorrhoidal prolapse by stapled haemorrhoidopexy (SH) and obstructed defaecation syndrome with the stapled transanal rectal resection (STARR) technique is becoming increasingly popular with patients and surgeons. Unfortunately, serious complications have been identified. The aim of the present study was to analyse the complications and their treatment to see where they might be avoided and to determine best management.

METHOD: All Units of Coloproctology belonging to the Italian Unitary Society of Coloproctology (SIUCP) were asked to return documentation of serious complications following SH and STARR.

RESULTS: Forty-six reports were received from 23 centres. Twenty-seven serious complications were reported. Twenty occurred after SH (13 PPH 03, 7 PPH 01) (Endo-surgery Inc., Cincinnati, Ohio, USA) and seven after STARR. Complications were treated by abdominal operation in nine patients [colostomy (3), ileostomy (2), Hartmann's resection (1) and anterior resection (1)].

CONCLUSION: Stapled haemorrhoidopexy and STARR can result in serious complications requiring major surgery for their treatment.