Comparison of a modifed anoscope and the purse-stringanoscope in stapled haemorrhoidopexy

Abstract

AIM:To compare the results of the anoscope of the PPH kit and a modified anoscope during stapled haemorrhoidopexy. METHODS:The hospital records of 37 patients who underwent stapled haemorrhoidopexy between 2001 and 2006 were reviewed. The purse-string suture anoscope in the PPH kit was used on 15 patients (Group 1), and the modified anoscope was used on 22 patients (Group 2). Demographic characteristics of the patients, operation time, surgeon's performance, analgesic requirement, and complications were compared. RESULTS: Operation time was significantly longer inGroup 1 (42.0 ± 8.4 min vs 27.7 ± 8.0 min, P = 0.039).The surgeons reported their operative performance as significantly better in Group 2 (the results of the assessments were poor in ten, medium in four and good in one in Group 1, while good in all patients in Group 2, P < 0.001). The need for haemostatic sutures was significantly higher in Group 1 (six cases) and was needed in two cases in Group 2 (P = 0.034). CONCLUSION:Operation time decreased and the surgeon's satisfaction increased with use of the modified anoscope, and fewer haemostatic sutures were required if the surgeon waited longer before and after firing the stapler.

Long-term outcomes of stapled hemorrhoidopexy.

“…The recurrence rate also depended on the degree of hemorrhoidal prolapse before the operation. This raises the question of how patients were selected [ 13 ] and whether different techniques should be selected for some groups of patients [ 14 , 15 ].…”