{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T10:34:48Z","timestamp":1792319688895,"version":"4.4.0"},"reference-count":29,"publisher":"FapUNIFESP (SciELO)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq. Gastroenterol."],"published-print":{"date-parts":[[2011,3]]},"abstract":"<jats:p>CONTEXT: Since anorectocele is usually associated with mucosa prolapse and\/or rectal intussusceptions, it was developed a stapled surgical technique using one circular stapler. OBJECTIVE: To report the results of Transanal Repair of Rectocele and Rectal Mucosectomy with one Circular Stapler (TRREMS procedure) in the treatment of anorectocele with mucosa prolapse in a prospective multicenter trial. METHODS: It was conducted by 14 surgeons and included 75 female patients, mean aged 49.6 years, with symptoms of obstructed defecation due to grade 2 (26.7%) and grade 3 (73.3%) anorectocele associated with mucosa prolapse and\/or rectal intussusception (52.0%) and an average validated Wexner constipation score of 16. All patients were evaluated by a proctological examination, cinedefecography, anal manometry and colonic transit time. The TRREMS procedure consists of the manual removal of the rectocele wall with circumferential rectal mucosectomy performed with a circular stapler. The mean follow-up time was 21 months. RESULTS: All patients presented obstructed defecation and they persisted with symptoms despite conservative treatment. The mean operative time was 42 minutes. In 13 (17.3%) patients, bleeding from the stapled line required hemostatic suture. Stapling was incomplete in 2 (2.6%). Forty-nine patients (65.3%) required 1 hospitalization day, the remainder (34.7%) 2 days. Postoperatively, 3 (4.0%) patients complained of persistent rectal pain and 7 (9.3%) developed stricture on the stapled suture subsequently treated by stricturectomy under anesthesia (n = 1), endoscopic stricturectomy with hot biopsy forceps (n = 3) and digital dilatation (n = 3). Postoperative cinedefecography showed residual grade I anorectoceles in 8 (10.6%). The mean Wexner constipation score decreased significantly from 16 to 4 (0-4: n = 68) (6: n = 6) (7: n = 1) (P&lt;0.0001). CONCLUSION: Current trial results suggest that TRREMS procedure is a safe and effective technique for the treatment of anorectocele associated with mucosa prolapse. The stapling technique is low-cost as requires the use of a single circular stapler.<\/jats:p>","DOI":"10.1590\/s0004-28032011000100002","type":"journal-article","created":{"date-parts":[[2011,4,29]],"date-time":"2011-04-29T07:56:55Z","timestamp":1304063815000},"page":"3-7","source":"Crossref","is-referenced-by-count":15,"title":["TRREMS procedure (transanal repair of rectocele and rectal mucosectomy with one circular stapler): a prospective multicenter trial"],"prefix":"10.1590","volume":"48","author":[{"given":"Jos\u00e9 Vinicius","family":"Cruz","sequence":"first","affiliation":[{"name":"Federal University of Porto Alegre"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco Sergio P.","family":"Regadas","sequence":"additional","affiliation":[{"name":"Federal University of Cear\u00e1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sthela Maria","family":"Murad-Regadas","sequence":"additional","affiliation":[{"name":"Federal University of Cear\u00e1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lusmar Veras","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"Federal University of Cear\u00e1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Benicio","sequence":"additional","affiliation":[{"name":"Bar\u00e3o de Lucena Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rog\u00e9rio","family":"Leal","sequence":"additional","affiliation":[{"name":"Bar\u00e3o de Lucena Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9sar G.","family":"Carvalho","sequence":"additional","affiliation":[{"name":"Hospital da Lagoa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margarete","family":"Fernandes","sequence":"additional","affiliation":[{"name":"Hospital do Servidor P\u00fablico Estadual"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucimar M. 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Moura","family":"Leal","sequence":"additional","affiliation":[{"name":"Federal University of Piau\u00ed, Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1007\/BF02056950","article-title":"A constipation scoring system to simplify evaluation and management of constipated patients","volume":"39","author":"Agachan F","year":"1996","journal-title":"Dis Colon Rectum","ISSN":"https:\/\/id.crossref.org\/issn\/0012-3706","issn-type":"print"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"1549","DOI":"10.1007\/s10350-004-6465-9","article-title":"Combined perineal and endorectal repair of rectocele by circular stapler: a novel surgical technique","volume":"45","author":"Altomare DF","year":"2002","journal-title":"Dis Colon 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