Long‐term results of stapled haemorrhoidopexy in a prospective single centre study of 153 patients with 1–6 years’ follow‐up

Abstract

Restoration of the anal anatomy by stapled haemorrhoidopexy resulted in a significant improvement in haemorrhoid-associated symptoms and continence but a third of patients had poor symptom control including 13% with persisting prolapse.

Does a more extensive mucosal excision prevent haemorrhoidal recurrence after stapled haemorrhoidopexy? Long‐term outcome of a randomized controlled trial

“… of 27 randomized controlled trials, the odds ratios for recurrent prolapse and re‐intervention for prolapse after SH compared with the MM operation were 4.34 and 6.78. Similarly, persisting haemorrhoidal symptoms and continence disturbance were found in the present study in one‐third of the patients after long‐term follow‐up with a rate of recurrent prolapse of 13% in a recent Swedish study . To overcome the problem of recurrent prolapse STARR was proposed by Boccasanta et al .…”

“…The persistence of haemorrhoidal symptoms and long-term recurrent prolapse using the PPH device has been highlighted in systematic reviews [13] and large case series [14,15]. In a systematic review by Burch et al [13] of 27 randomized controlled trials, the odds ratios for recurrent prolapse and re-intervention for prolapse after SH compared with the MM operation were 4.34 and 6.78.…”

“…The persistence of haemorrhoidal symptoms and long‐term recurrent prolapse using the PPH device has been highlighted in systematic reviews and large case series . In a systematic review by Burch et al .…”

Tailored prolapse surgery for the treatment of hemorrhoids with a new dedicated device: TST Starr plus

“…Compared with excisional hemorrhoidectomy, stapled hemorrhoidopexy is more favorable in terms of postoperative discomfort [2,3], shorter length of hospital stay, time until return to work, and high patient satisfaction [4,5]. However, stapled procedure seems to be associated with some disadvantages as high recurrence rate (range 0-26 %) [6][7][8] and postoperative complications [9][10][11][12]. A recent retrospective multicenter study identified the criticism in the use of the conventional staplers reporting some serious complications as hematoma, bleeding, rectovaginal fistula, sepsis or perineal necrosis, important anastomotic defects, and closing up of rectum with stapler [13].…”

Long-term outcomes of high-volume stapled hemorroidopexy to treat symptomatic hemorrhoidal disease

“…Several clinical studies have demonstrated that stapled hemorrhoidopexy (SH) is associated with less operating time, less pain, shorter hospital stay with an earlier return to normal activities and also improves symptoms of obstructed defecation that are frequently reported in these patients [4][5][6][7][8][9][10][11][12]. However, the recurrence rate and the need for further surgical procedures are higher if compared to the conventional hemorrhoidectomy [13][14][15][16]. Anyhow, these results come from the use of first-generation devices which had some limita-tions due to the low casing volume, whereby trying to improve the outcomes, new generation devices with high-volume casing were delivered on market [17].…”