A New Approach for Hemorrhoid Disease: Selective Dearterialization and Mucopexy Without Doppler Guidance

Sobrado, Carlos Walter; Sobrado, Lucas Faraco; Nahas, Sérgio Carlos; Ivan, Cristina

doi:10.1590/0102-672020210001e1560

Cited by 3 publications

(1 citation statement)

References 9 publications

(10 reference statements)

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“…New surgical procedures for the surgical treatment of HD, with less invasive techniques, have been developed, such as PPH, THD-M, and LigaSure, with the aim of reducing postoperative pain and shortening the return to regular activities 36 , 37 .…”

Section: Discussionmentioning

confidence: 99%

Stapled Hemorrhoidopexy: Results, Late Complications, and Degree of Satisfaction After 16 Years of Follow-Up

Sobrado

Obregon

et al. 2022

ABCD, arq. bras. cir. dig.

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BACKGROUND: Stapled hemorrhoidopexy has been widely used for the treatment of hemorrhoids, but concerns about complications and recurrences after prolonged follow-up are still under debate. AIMS: The aim of this study was to evaluate the very long-term results of the stapled hemorrhoidopexy technique. METHODS: Stapled hemorrhoidopexy was performed on 155 patients between 2000 and 2003, and the early results have already been published. In this study, we evaluated the same patients after a very long follow-up. Data were collected with regard to late complications, rate and timing of recurrences, and patients' degree of satisfaction. RESULTS: From a total of 155 patients, 98 patients were evaluated: 59 (60.2%) were interviewed by telephone and 39 (39.8%) were evaluated by outpatient consultation. The mean follow-up was 193 months (range: 184-231), 52 were female, 52 were grade III hemorrhoids, and 46 were grade IV. Recurrence was higher in grade IV (26.1%) than in grade III (7.7%) (p=0.014). Recurrence after prolonged follow-up was seen in 16 patients (16.3%) and 11 (11.2%) required reoperations. The complications were skin tags (3.1%), anal sub-stenosis (2.1%), and fecal incontinence (2.1%). After a prolonged follow-up, 82.5% of patients were either very satisfied or satisfied with the surgery. CONCLUSIONS: Stapled hemorrhoidopexy is a safe and effective treatment for hemorrhoidal disease grades III and IV. Recurrence is higher for grade IV hemorrhoids and may occur up to 9 years of follow-up. Reoperations were infrequent and there is a high patient's degree of satisfaction associated with this technique.

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Section: Discussionmentioning

confidence: 99%

Stapled Hemorrhoidopexy: Results, Late Complications, and Degree of Satisfaction After 16 Years of Follow-Up

Sobrado

Obregon

et al. 2022

ABCD, arq. bras. cir. dig.

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A retrospective comparative study of hemorrhoidal artery ligation versus ligasure hemorrhoidectomy for the third degree hemorrhoidal disease

Onder,

Altiok

2023

Asian Journal of Surgery

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Three Years Recurrence Free of Hemorrhoid Artery Ligation-Rectoanal Repair with No Doppler Guided on Grade III of Internal Hemorrhoid Disease

Bagus

2023

Open Access Maced J Med Sci

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BACKGROUND: Surgical treatment of internal hemorrhoid is still challenging, short- and long-term clinical outcome were the most common issue. Chronic pain and recurrence case are the most common problem. Since it has been announced, HAL-RAR with Doppler guided is the treatment of choice, although it has economic issue on using this standard technique especially in the developing country which has limitation on health insurance. AIM: Using the same procedure as the standard HAL-RAR procedure and direct vision ligation, we hope that it could evaluate the clinical response of these modification technique on symptomatic Grade III of internal hemorrhoid cases. METHODS: We will evaluate the long-term clinical outcome of modified no Doppler guided technique on grade III of internal hemorrhoid cases. The inclusion criteria are the grade III of internal hemorrhoid, not associated with rectal cancer. A history of previous procedure or recurrence disease will be excluded from the study. Post-operative pain, 3 years recurrence disease, will be evaluated. RESULTS: We reported 65 patients, both of them have pain and bleeding. The procedure can be performed safely using direct vision and rectoscope. After 3 years, we reported there was no recurrence disease, no post-operative bleeding, and tolerable post-operative pain. We reported one case of chronic pain due to proctitis and could be managed conservatively. CONCLUSION: No Doppler-guided HAL-RAR was effective in controlling the post-operative pain, acceptable long-term clinical outcome with no recurrence.

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A New Approach for Hemorrhoid Disease: Selective Dearterialization and Mucopexy Without Doppler Guidance

Cited by 3 publications

References 9 publications

Stapled Hemorrhoidopexy: Results, Late Complications, and Degree of Satisfaction After 16 Years of Follow-Up

Stapled Hemorrhoidopexy: Results, Late Complications, and Degree of Satisfaction After 16 Years of Follow-Up

A retrospective comparative study of hemorrhoidal artery ligation versus ligasure hemorrhoidectomy for the third degree hemorrhoidal disease

Three Years Recurrence Free of Hemorrhoid Artery Ligation-Rectoanal Repair with No Doppler Guided on Grade III of Internal Hemorrhoid Disease

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