Randomised controlled clinical trial of stapled haemorrhoidectomy <i>vs</i> conventional haemorrhoidectomy; a three and a half year follow up

Au-Yong, Iain; Rowsell, M; Hemingway, D.

doi:10.1111/j.1463-1318.2004.00496.x

Cited by 57 publications

(65 citation statements)

References 5 publications

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“…However, in the recent literature, a significant incidence of recurrence after stapled hemorrhoidopexy was reported. In studies evaluating stapl ed hem orrhoid opexy and conventional hemorrhoidectomy for Grade III and IV hemorrhoids with an adequate and systematic follow-up (>1 year), the incidence of recurrence was 0 to 26 % and 0 to 10.8 %, respectively; reoperation rate was up to 16.7 % after stapled hemorrhoidopexy [43,46,61,[63][64][65][70][71][72]. After conventional Ferguson's hemorrhoidectomy, a redo surgery for recurrent hemorrhoids was necessary in 0.8 % of cases in a large series [73].…”

Section: Resultsmentioning

confidence: 99%

“…In most patients, incontinence is transitory, due to excessive anal stretching secondary to circular anal dilator insertion [62]. At long-term follow-up, persistent continence problems were reported in a minority of patients with no significant difference with respect to conventional hemorrhoidectomy [61,[63][64][65]. Similarly, fecal urgency is a common complication especially soon after stapled hemorrhoidopexy.…”

Section: Complicationsmentioning

confidence: 99%

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Clinical Outcome Following Hemorrhoid Surgery: a Narrative Review

Picchio¹,

Greco²,

Filippo

et al. 2014

Indian J Surg

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Surgical therapy guaranties satisfactory results, which are significantly better than those obtained with conservative therapies, especially for Grade III and IV hemorrhoids. In this review, we present and discuss the results of the most diffuse surgical techniques for hemorrhoids. Traditional surgery for hemorrhoids aims to remove the hemorrhoids, with closure (Fergusson's technique) or without closure (Milligan-Morgan procedure) of the ensuing defect. This traditional approach is effective, but causes a significant postoperative pain because of wide external wounds in the innervated perianal skin. Stapled hemorrhoidopexy, proposed by Longo, has gained a vast acceptance because of less postoperative pain and faster return to normal activities. In the recent literature, a significant incidence of recurrence after stapled hemorrhoidopexy was reported, when compared with conventional hemorrhoidectomy. Double stapler hemorrhoidopexy may be an alternative to simple stapled hemorrhoidopexy to reduce the recurrence in advanced hemorrhoidal prolapse. Transanal hemorrhoidal deartertialization was showed to be as effective as stapled hemorrhoidopexy in terms of treatment success, complications, and incidence recurrence. However, further high-quality trials are recommended to assess the efficacy and safety of this technique.

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Section: Resultsmentioning

confidence: 99%

Section: Complicationsmentioning

confidence: 99%

Clinical Outcome Following Hemorrhoid Surgery: a Narrative Review

Picchio¹,

Greco²,

Filippo

et al. 2014

Indian J Surg

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“…The rate of bleeding reportedly ranges between 5% and 85% [9,13,17,22] . The rates of bleeding in the PA group and in the MA group in the present study were 33.3% and 31.8%, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…It has been reported that patients with a stapler line uniformly 22 mm above the dentate line needed fewer postoperative narcotic analgesics and returned to work earlier [1] . In the case of an incomplete donut or a donut with thin parts, this may increase the risk of bleeding during the early postoperative period or recurrence in the late period [17] . Various modifications of the purse-string anoscope have been used for easier application of the suture and a new anoscope has been designed [10][11][12]18,19] .…”

Section: Discussionmentioning

confidence: 99%

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

Bozdağ¹,

Yaman²,

Derıcı³

et al. 2009

WJG

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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.

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“…DVSC procedures represent an easy way of treating hemorrhoids leading to immediate arrest of bleeding, regression in size of prolapsed hemorrhoidal cushions, it is a day case surgery, less complicated, easy to perform, and does not require a special needs such as Doppler sounder or expensive stapler instruments [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20].…”

Section: Discussionmentioning

confidence: 99%

Preliminary report of a new method of surgical treatment of hemorrhoids

Kubtan¹

2015

Glob Surg

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When conservative treatment fails, many invasive techniques developed to treat hemorrhoids. This study aims to compare the results of method designed by the author. (Disconnection of Systemic from Visceral Circulation at the anal canal DSVC) with the classical surgery known as Milligan & Morgan approach M&M. We conducted controlled, non-blinded, randomized study, involved 72 patients, took place under the supervision of one surgeon (the author) in Damascus hospital in Syria. For DVSC the mean procedures time (10 +/-0) minutes (ranged between 8-21 minutes) and duration of hospitalization 4 ± 2 hours post operatively.The mean procedures time for M&M (20 ± 0) minutes (ranged between 18-35 minutes) and hospitalized for two day post-operatively. We recommend DSVC method for 2 nd , 3 rd degree and prolapsing hemorrhoids, it is easy to perform, not associated with serious complications and has a good and satisfactory results. Compared to other surgical procedures, less painful, blood stained anal discharge but no actual bleeding , and does not require specific device (Doppler sounder), or Stapler, and satisfy the patient.

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Randomised controlled clinical trial of stapled haemorrhoidectomy vs conventional haemorrhoidectomy; a three and a half year follow up

Abstract: It will be important to review the long-term results of larger trials.

Cited by 57 publications

References 5 publications

Clinical Outcome Following Hemorrhoid Surgery: a Narrative Review

Clinical Outcome Following Hemorrhoid Surgery: a Narrative Review

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

Preliminary report of a new method of surgical treatment of hemorrhoids

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