Long-term outcome of a multicentre randomized clinical trial of stapled haemorrhoidopexy <i>versus</i> Milligan–Morgan haemorrhoidectomy

Ganio, Ezio; Altomare, D. F.; Milito, G; Gabrielli, Francesco; Canuti, Stefano

doi:10.1002/bjs.5677

Cited by 84 publications

(73 citation statements)

References 36 publications

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“…7,8 Few complications were specific to stapled hemorrhoidopexy; however, these included failure of the stapling gun, urosepsis, and pelvic sepsis. The most common complication was early bleeding, with the overall rate following the procedure ranging from 0 to 68%.…”

Section: Resultsmentioning

confidence: 99%

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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Section: Resultsmentioning

confidence: 99%

Documented Complications of Staple Hemorrhoidopexy: A Systematic Review

Porrett

2015

International Surgery

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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%

“…The upper replacement instead of excision of the piles, carried out by stapled hemorrhoidopexy, should reduce postoperative incontinence, as hemorrhoids are important factors of anal continence. However, postoperative incontinence after stapled hemorrhoidectomy was reported in up to 28 % of cases [61]. In most patients, incontinence is transitory, due to excessive anal stretching secondary to circular anal dilator insertion [62].…”

Section: Complicationsmentioning

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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“…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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Long-term outcome of a multicentre randomized clinical trial of stapled haemorrhoidopexy versus Milligan–Morgan haemorrhoidectomy

Abstract: Both techniques are effective in the long term.

Cited by 84 publications

References 36 publications

Documented Complications of Staple Hemorrhoidopexy: A Systematic Review

Documented Complications of Staple Hemorrhoidopexy: A Systematic Review

Clinical Outcome Following Hemorrhoid Surgery: a Narrative Review

Preliminary report of a new method of surgical treatment of hemorrhoids

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