Emerging technologies in coloproctology: results of the Italian Society of Colorectal Surgery Logbook of Adverse Events.

Basso L;Pescatori M;La Torre F;Destefano I;Pulvirenti D'Urso A;Infantino A;Amato A;Altomare DF;Amato A;Basso L;Bianco V;Binda G;Boffi F;Bottini C;Carrino F;Casula G;Cavicchi A;Codacci Pisanelli M;De Nardi P;Destefano I;Dodi G;Fucini C;Gaj F;Gentile M;Iachino C;Indinnimeo M;Infantino A;La Torre F;Mancini S;Mattana C;Nemati Fard M;Pescatori M;Pietroletti R;Pulvirenti D’Urso A;Rinaldi M;Ripetti V;Spinelli F;Tricomi N;Veronesi P;ZORCOLO, LUIGI

2013-01-01

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Abstract

Background: The aim of this paper is to present the results of the Italian Society of Colorectal Surgery [or Società Italiana di Chirurgia Colorettale (SICCR)] Logbook of adverse events (AE) occurring in relation to emerging technologies in coloproctology (ETCs), over a 3-year period. METHODS: A total of 245 AE were reported (patients age: mean = 49.6 years, range = 20-75 years; gender: 155 = F, 90 = M). The "observations" originated from the same institution of the AEs in 44 cases (18.0%), while 201 patients (82.0%) had been operated on somewhere else. RESULTS: The three most reported ETCs were: Procedure for prolapsed haemorrhoids (PPH) (n = 120-48.9%), stapled transanal rectal resection (STARR (n = 96-39.2%), and transanal haemorrhoidal dearterialization (THD) (n = 11-4.5%). PPH, STARR, and THD together accounted for n = 227 (92.6%) observations. For the three main reported ETCs, the various AEs are listed. Chronic pain after PPH was 46/120 (38.3%), and after STARR of 21/96 (21.9%). The overall re-operation rate was n = 135 (55.1%) versus n = 110 (44.9%) no reoperation. In particular, for the three main reported ETCs, n = 68/120 (56.7%) following an AE after PPH, n = 47/94 (50.0%) following an AE after STARR, and n = 6/11 (54.5) following an AE post-THD. The various types of treatment to solve AE after each of the three most observed ETCs are reported in the text. CONCLUSIONS: Our results do not allow us to draw statistical conclusions; however, this was not the aim of our survey. ETCs are important, yet they are not without major risks. Manufacturers should help colorectal surgeons to convey the right message to patients.