Tailored mucosectomy and haemorrhoidopexy (<scp>TM</scp> &amp; H): A new surgical option for selected Goligher grade <scp>III</scp> haemorrhoids – a video vignette

Elbetti, C.; Giani, Iacopo; Caminati, Filippo; Cioppa, Tommaso; Linari, Chiara; Zalla, Tiku

doi:10.1111/codi.16338

Cited by 1 publication

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“…Finally, there are new proposals for classifications of HD, as BPRST (bleeding, prolapse, reducibility, skin tags and thrombosis) waiting for validation before applicable in clinical practice [13]. These classifications are designed to improve the therapeutic indication by taking into consideration the symptoms related to the HD but the appropriate therapy is closely linked to the character of the prolapse in the case of III-degree [9][10][11]14].…”

Section: Discussionmentioning

confidence: 99%

A Case Series of Large Volume Iii-Degree Hemorrhoidal Disease: A Special Anatomical Condition Requiring Surgical Treatment

Pietroletti¹

2023

JSRP

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Background: Haemorrhoidal Disease (HD) is common and impacts negatively on quality of life with high socio-economic costs. Despite international guidelines aimed to indicate appropriate care in HD, treatment of III-degree HD remains controversial due to the wide range of ambulatory or surgical procedures available. We aimed to analyse treatment options for III-degree HD focusing on special cases characterized by large volume and/or circumferential presentation of intermittent prolapse or recurrence after conservative treatments. Methods: In the period January 2017- December 2018 out of 152 patients treated by excisional haemorrhoidectomy, we collected a case series of 29 patients affected by III-degree symptomatic HD. They showed a very large, single prolapse or circumferential one or failure of previous conservative treatments. Results: 14 (48.2%) patients (median age 45 yrs.) of our series were recurrence of HD following Rubber Band Ligation (RBL) (5pts), Dearterialization (DEART) (5pts), Stapled Haemorrhoidopexy (SH) (4pts). Mean operative time was 35 min. Postoperative severe pain (6.8%) and urinary retention (17.2%) were the main postoperative complications which did not affect the length of stay. All patients showed a good outcome without any complication at follow-up. Conclusion: III-degree HD shows the highest variability in anatomical presentation, and proposed treatment. Thus, the choice of a personalized approach must rely upon objective evaluation of volume of prolapse. Intermittent prolapse, if very large or circumferential, associated or not to large external haemorrhoids, makes a special condition III degree HD, suggesting surgical excision, avoiding conservative approaches.

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Section: Discussionmentioning

confidence: 99%

A Case Series of Large Volume Iii-Degree Hemorrhoidal Disease: A Special Anatomical Condition Requiring Surgical Treatment

Pietroletti¹

2023

JSRP

View full text Add to dashboard Cite

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Tailored mucosectomy and haemorrhoidopexy (TM & H): A new surgical option for selected Goligher grade III haemorrhoids – a video vignette

Cited by 1 publication

References 3 publications

A Case Series of Large Volume Iii-Degree Hemorrhoidal Disease: A Special Anatomical Condition Requiring Surgical Treatment

A Case Series of Large Volume Iii-Degree Hemorrhoidal Disease: A Special Anatomical Condition Requiring Surgical Treatment

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