Mucopexy-recto anal lifting: a standardized minimally invasive method of managing symptomatic hemorrhoids, with an innovative suturing technique and the HemorPex System®

Pagano, Claudio; Vergani, Contardo; Invernizzi, Carlo; Bussone, M; Benegiamo, Guido; Venturi, Marco

doi:10.23736/s0026-4733.18.07425-4

Cited by 10 publications

(8 citation statements)

References 13 publications

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“…Mu-RAL is best for circumferential G-II to G-III hemorrhoids without an external hemorrhoidal component or internal hemorrhoids with rectal mucosal prolapse because of the rectal mucosal elevation hemorrhoid lifting. G-IV rhoids are not due to the difficulty of complete lifting [11][12][13].…”

Section: Indications For Surgerymentioning

confidence: 99%

“…Six surgical operations are performed starting at 11 o'clock in the order of 1, 9, 3, 7, and 5 o'clock to raise and fix the entire fragile rectal mucosa, submucosa, and prolapsed hemorrhoids. In other words, it is a technique to cure prolapse by suturing and elevating at the same time without resection [11][12][13].…”

Section: Operation Techniquementioning

confidence: 99%

“…Depending on the pathogenesis of the hemorrhoid, treatment op-tions have expanded to include ALTA alone, a combination of LE and ALTA, and LE alone [1][2][3][4][5][6][7][8][9]. Furthermore, the Procedure for Prolapse and Hemorrhoid, Anal Cushion Lifting, and Mucopexy-Recto Anal Lifting (MuRAL) have been developed to elevate hemorrhoids by suturing the rectal mucosa [10][11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

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Treatment Result of the Mucopexy-Recto Anal Lifting Method for Hemorrhoids in Comparison with Ligation and Excision, and Aluminum Potassium Sulfate and Tannic Acid Sclerotherapy

Sameshima

Niwa

Eto

et al. 2022

J Anus Rectum Colon

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The outcomes of Mucopexy-Recto Anal Lifting (MuRAL) in hemorrhoid surgery were compared with ligation and excision (LE), and aluminum potassium sulfate and tannic acid sclerotherapy (ALTA). In this study, we conducted a 3-year follow-up study of MuRAL (380 cases) and compared it with LE (1417 cases) and ALTA (541 cases) performed at the same period. Operative time, mean hospital stay, postoperative pain, postoperative complications, and recurrence were compared and examined retrospectively. The mean operative time was the longest for MuRAL, followed by LE, and then ALTA at 29.1, 21.5, and 12.4 minutes, and the mean length of hospital stay was 6.2, 10.6, and 1.3, days, respectively. Based on the frequency of injectable analgesic use, postoperative pain was clearly milder in MuRAL and ALTA than in LE. The recurrence rates were 3.2% with MuRAL, 1.1% with LE, and 12.4% with ALTA. Early postoperative low-grade fever and bowel movement urgency were observed in all surgeries, but these were minor and did not pose a safety problem. LE is painful and requires prolonged hospitalization but is the most curative; ALTA is simple and can be performed as a day surgery but has a high recurrence rate. MuRAL was less painful than LE and had a lower recurrence rate than ALTA. In recent years, there have been various innovations in the surgical treatment of hemorrhoids, and choosing a technique that is appropriate for the condition of the hemorrhoid and patient's needs is necessary. MuRAL can be one of the options for hemorrhoid treatment as a "cure without cutting" method.

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Section: Indications For Surgerymentioning

confidence: 99%

Section: Operation Techniquementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Treatment Result of the Mucopexy-Recto Anal Lifting Method for Hemorrhoids in Comparison with Ligation and Excision, and Aluminum Potassium Sulfate and Tannic Acid Sclerotherapy

Sameshima

Niwa

Eto

et al. 2022

J Anus Rectum Colon

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“…Fifth degree (complicated) hemorrhoids are first treated conservatively followed by operative treatment (if needed). Hemorrhoidectomy is one of the most commonly performed anorectal operations (8) International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited ultrasonic blade, LigaSure, Doppler-guided hemorrhoidal artery ligation, and mucopexy (recto-anal repair) (5,7,(9)(10)(11)(12). The aim of these modifications is to decrease postoperative pain, reduce bleeding, make healing, and resumption of normal activities faster (9).…”

Section: Introductionmentioning

confidence: 99%

Comparative Analysis of Triple Hemostatic Open Hemorrhoidectomy Versus Traditional Open Hemorrhoidectomy

Shamim¹

2018

Ann Colorectal Res

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Background: Traditional open hemorrhoidectomy is the most commonly performed operation for the third or fourth degree hemorrhoids in the developing world, despite considerable postoperative pain and bleeding complications. This modification is an attempt to reduce these complications and compare the outcome of both methods. Methods: A prospective, comparative study was conducted in phase I, at Fatima hospital at Baqai Medical University, from March 2009 to August 2011. It was followed by a descriptive case-series in phase II, conducted at different hospitals from September 2011 to August 2017. The inclusion criteria were patients of both genders and all age groups, with third or fourth degree hemorrhoids requiring surgery. The exclusion criteria were patients in between blocks (operated by other surgeons), patients with complicated hemorrhoids, closed hemorrhoidectomy cases, cases operated by residents, and cases lost to follow-up. In phase I, a total of 182 patients were enrolled and randomly allocated to group A or B undergoing triple hemostatic hemorrhoidectomy and traditional open hemorrhoidectomy, respectively; 231 patients were included in phase II (group C) undergoing modified hemorrhoidectomy. The analyzed variables were operative blood loss, operative time, postoperative pain, hospital stay, time to pain-free defecation, and per-operative or postoperative complications. Results: There was significantly more operative blood loss in group B patients. Pain perception was significantly high in group B patients at eight and 24 hours, as well as eighth, 15th, and 30th days. Group B patients also had longer duration of operation and more prolonged pain-free defecation. Both, intra-operative and post-operative complications were higher among the group B. The outcome of phase II (group C) was similar to those of group A. Conclusions: In a limited resource setting, triple hemostatic open hemorrhoidectomy offers potential advantages of less operative blood loss, shorter duration of operation, shortened hospital stay, shorter time to pain free defecation, and less postoperative pain and other complications.

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“…Of course, it may be difficult to future proof a standard technique. PPH, DG HAL and even haemorrhoidectomy have undergone modifications to the 'standard technique' over the years with each published modification proclaiming superior results [6][7][8].…”

mentioning

confidence: 99%

Offering HeLP to work out the optimum treatment for haemorrhoidal disease

Brown

Lee

2018

Tech Coloproctol

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Mucopexy-recto anal lifting: a standardized minimally invasive method of managing symptomatic hemorrhoids, with an innovative suturing technique and the HemorPex System®

Abstract: In our series up to 88% of the patients reported a good, or excellent one-year satisfaction score. Further comparative randomized studies with longer follow-up period are needed.

Cited by 10 publications

References 13 publications

Treatment Result of the Mucopexy-Recto Anal Lifting Method for Hemorrhoids in Comparison with Ligation and Excision, and Aluminum Potassium Sulfate and Tannic Acid Sclerotherapy

Treatment Result of the Mucopexy-Recto Anal Lifting Method for Hemorrhoids in Comparison with Ligation and Excision, and Aluminum Potassium Sulfate and Tannic Acid Sclerotherapy

Comparative Analysis of Triple Hemostatic Open Hemorrhoidectomy Versus Traditional Open Hemorrhoidectomy

Offering HeLP to work out the optimum treatment for haemorrhoidal disease

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