Stapled Hemorrhoidopexy vs. Diathermy Excision for Fourth-Degree Hemorrhoids: A Randomized, Clinical Trial and Review of the Literature

Ortiz, Héctor; Marzo, José Fernando Cariñena; Armendáriz, P.; Miguel, Mario

doi:10.1007/s10350-004-0861-z

Cited by 124 publications

(175 citation statements)

References 22 publications

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“…In group A, 11 patients were having satisfactory outcome and in group B, 8 patients were have satisfactory outcome. When results of two groups were compared for postoperative pain it shows significant statistical difference in between two groups like those of the other controlled studies conducted by Ortiz H et al 18 and Rowsell M et al 19 reported in the literature, 20 the results reported here show that stapled hemorrhoidectomy is associated with significantly less postoperative discomfort than conventional hemorrhoidectomy.…”

Section: Resultssupporting

confidence: 75%

Hemorrhoidectomy; Stapled Versus Conventional Hemorrhoidectomy in Terms of Post-Operative Pain and Hospital Stay

Ahmed

Ahmad

Amjid

et al. 2017

TPMJ

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ABSTRACT… Objectives: Is to compare outcomes in terms of mean post-operative pain and hospital stay between stapled versus conventional hemorrhoidectomy. Hypothesis: There is a difference in mean post-operative pain and hospital stay between stapled and conventional hemorrhoidectomy, stapled technique is better than conventional technique. Study Design: Randomized control trial. Setting: Department of General Surgery Bakhtawar Amin Memorial Hospital Multan. Period: February 2016 February 2017. Methodology: A total number of 60 patients enrolled in the study, both genders. Statistical software SPSS ver.23 was used to analyze the data. Mean and SD were calculated and presented for numerical variables like duration of hemorrhoids, age and pain score while frequencies and percentage were calculated and presented for categorical variables like ender and grade of hemorrhoids. Independent t-test and chi square test were applied to see effect modification. P value ≤0.05 was considered as significant. Results: Total number of 60 (100%) patients in the study, 32 (53.3%) were male and 28 (46.7 %) were female. Mean hospital stay in group A was 1.63 ± 0.71 and in group B means duration of hospital stay was 1.73 ± 0.74. A P value was 0.001. On stratification of data it is concluded that in group A 9 patients have no pain 6 have mild and 6 have moderate pain and 5 patients have severe pain, similarly in group B, 3 patients have no pain 2 have mild pain 1 have moderate pain and no patient have severe pain. P value for male patients was 2.65. Conclusion: This study confirms that stapled hemorrhoidectomy is associated with less postoperative pain with no effect of age and gender on outcome.

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Section: Resultssupporting

confidence: 75%

Hemorrhoidectomy; Stapled Versus Conventional Hemorrhoidectomy in Terms of Post-Operative Pain and Hospital Stay

Ahmed

Ahmad

Amjid

et al. 2017

TPMJ

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“…8,23 Tenesmus was more commonly reported in stapled hemorrhoidopexy and authors have attributed this to the presence of a low rectal suture. 21 Intramural fistulization was reported in 0.02% of cases, all on the staple line, and required clearance and elastic drainage for management. 23 Submucosal anastomotic cysts were reported postoperatively and these were associated with the retention of fecolith material at the anastomotic level.…”

Section: Discussionmentioning

confidence: 99%

“…3,[17][18][19][20] Early thrombosed external hemorrhoids (TEH) were also reported, with the overall early occurrence rate ranging from 0 to 13% and a median occurrence of 4.51%. 21 Overall rates of urinary retention ranged from 0 to 22%. 6 Few articles documented whether or not urinary catheterization was required to treat the retention.…”

Section: -16 Documented Complications Of Hemorrhoidopexy Porrettmentioning

confidence: 99%

“…23,24 Fecal impaction was also reported. 6,21,25,26,27 Early complications including anastomotic dehiscence and edema of the anastomotic ring were also reported. 3,8,20,28 Late Complications Late complications were those occurring postoperatively after 7 days, listed in Table 2.…”

Section: -16 Documented Complications Of Hemorrhoidopexy Porrettmentioning

confidence: 99%

“…25 Tenesmus was more commonly reported in stapled hemorrhoidopexy than other methods of hemorrhoidectomy and occurrence rates ranged from 0 to 40%. 21 Intramural fistulization was reported in 0.02% of cases, all were on the staple line and required clearance and elastic drainage for management. 23 Submucosal anastomotic cysts were reported.…”

Section: -16 Documented Complications Of Hemorrhoidopexy Porrettmentioning

confidence: 99%

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Documented Complications of Staple Hemorrhoidopexy: A Systematic Review

Porrett

2015

International Surgery

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A systematic review addressing reported complications of stapled hemorrhoidopexy was conducted. Articles were identified via searching OVID and MEDLINE between July 2011 and October 2013. Limitations were placed on the search criteria with articles published from 1998 to 2013 being included in this review. No language restrictions were placed on the search, however foreign language articles were not translated. Two reviewers independently screened the abstracts for relevance and their suitability for inclusion. Data extraction was conducted by both reviewers and entered and analyzed in Microsoft Excel. The search identified 784 articles and 78 of these were suitable for inclusion in the review. A total of 14,232 patients underwent a stapled hemorrhoidopexy in this review. Overall complication rates of stapled hemorrhoidopexy ranged from 3.3%-81% with 5 mortalities documented. Early and late complications were defined individually with overall data suggesting that early complications ranged from 2.3%-58.9% and late complications ranged from 2.5%-80%. Complications unique to the procedure were identified and rates recorded. Both early and late complications unique to stapled hemorrhoidopexy were identified and assessed.

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