Partial Stapled Hemorrhoidopexy Versus Circumferential Stapled Hemorrhoidopexy for Grade III to IV Prolapsing Hemorrhoids: A Randomized, Noninferiority Trial

Lin, Hong Cheng; He, Q.; Shao, Wan Jin; Chen, Xin Lin; Peng, Hui; Xie, Shang Kui; Wang, Xiao Xue; Ren, Dong

doi:10.1097/dcr.0000000000001261

Cited by 22 publications

(22 citation statements)

References 31 publications

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“…For the remaining studies, the full texts were obtained and reviewed. Seven studies were excluded based on reasons listed in Table 1 [12][13][14][15][16][17][18]. Cumulatively, 17 articles (15 case reports and two case series) were considered relevant, and 38 patients were included ( Figure 1, Seven papers reported perirectal hematoma [3,17,18,[20][21][22][23][24][25][26][27].…”

Section: Resultsmentioning

confidence: 99%

“…For the remaining studies, the full texts were obtained and reviewed. Seven studies were excluded based on reasons listed in Table 1 [ 12 , 13 , 14 , 15 , 16 , 17 , 18 ]. Cumulatively, 17 articles (15 case reports and two case series) were considered relevant, and 38 patients were included ( Figure 1 , Table 2 ) [ 3 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 ].…”

Section: Resultsmentioning

confidence: 99%

“…The data about hemodynamic status were reported in all case reports and the case series [ 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 ]: a hemodynamic instability was reported in a few cases (18.9%, 7/37) and a hemodynamic stabilization and resuscitation were needed.…”

Section: Resultsmentioning

confidence: 99%

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Perirectal Hematoma and Intra-Abdominal Bleeding after Stapled Hemorrhoidopexy and STARR—A Proposal for a Decision-Making Algorithm

et al. 2020

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Background and Objectives: The present study aims to assess the effectiveness and current evidence of the treatment of perirectal bleeding after stapled haemorrhoidopexy. Materials and methods: A systematic literature review was performed that combined the published and the obtained original data after a search of PubMed, Web of Science, and SCOPUS. Results: The present systematic review includes 16 articles with 37 patients. Twelve papers report perirectal and six report intra-abdominal bleeding. Stapled hemorrhoidopexy (SH) was performed in 57% of cases (3 PPH 01 and 15 PPH 03), stapled transanal rectal resection (STARR) in 13%, and for 30% information was not available. The median age was 49 years (±11.43). The sign and symptoms of perirectal bleeding were abdominal pain (43%), pelvic discomfort without rectal bleeding (36%), urinary retention (14%), and external rectal bleeding (21%). The median time to bleeding was 1 day (±1.53 postoperative days), with median hemoglobin at diagnosis 8.8 ± 1.04 g/dL. Unstable hemodynamic was reported in 19%. Computed tomography scan (CT) was the first examination in 77%. Only two cases underwent the abdominal US, but subsequently, a CT scan was also conducted. Non-operative management was performed in 38% (n = 14) with selective arteriography and percutaneous angioembolization in two cases. A surgical treatment was performed in 23 cases—transabdominal surgery (3 colostomies, 1 Hartmann’ procedure, 1 low anterior resection of the rectum, 1 bilateral ligation of internal iliac artery and 1 ligation of vessels located at the rectal wall), transanal surgery (n = 13), a perineal incision in one, and CT-guided paracoccygeal drainage in one. Conclusions: Because of the rarity and lack of experience, no uniform tactic for the treatment of perirectal hematomas exists in the literature. We propose an algorithm similar to the approach in pelvic trauma, based on two main pillars—hemodynamic stability and the finding of contrast CT.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Perirectal Hematoma and Intra-Abdominal Bleeding after Stapled Hemorrhoidopexy and STARR—A Proposal for a Decision-Making Algorithm

et al. 2020

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“…Regarding Scenario 2, diverticulum formation does not necessarily result from failure to achieve complete resection along the circumference of the anastomosis. In terms of postoperative complications after SH, a recent study reported partial SH as a new procedure to potentially reduce the rates of several morbidities associated with conventional SH, including anastomotic stenosis, rectovaginal fistula, defecatory dysfunction, and RPS [13]. Additionally, the partial SH procedure, which is performed by preserving the mucosal bridges, is noninferior to SH.…”

Section: Discussionmentioning

confidence: 99%

Evacuatory Dysfunction after Stapled Hemorrhoidopexy: A Case Report of Rectal Pocket Syndrome

Maejima

Kono

Fukahori

et al. 2020

J Anus Rectum Colon

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A 60 year-old male was referred to the authors' hospital with a persistent urge to defecate. The patient had undergone stapled hemorrhoidopexy (SH) for the treatment of prolapsed hemorrhoids approximately 10 years earlier. He started to have difficulty with defecation and a false sense of urgency shortly after the surgery. Computed tomography showed a diverticulum-like fistula along the circumference of the rectum. Colonoscopy revealed communication between the diverticular cavity and the rectal lumen. The cavity contained a thumbnail-sized fecalith. When the fecalith was removed, the patient's urge to defecate dissipated. The patient was diagnosed with rectal pocket syndrome secondary to SH. The lower rectum was transected, and the remaining rectum and the anal canal were anastomosed by manual suture. Temporary ileostomy with double orifices was performed. The ileostomy was closed 3 months later. The patient experienced no subsequent difficulty with defecation or urgency.

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“…Today, hemorrhoids are characterized by their relevance among coloproctological diseases. There is many data on the pathogenesis and course of hemorrhoidal disease, the clinical picture of hemorrhoids, which is diverse in a wide range and requires careful differential diagnosis [1,2,3].…”

Section: Introductionmentioning

confidence: 99%

Morphological Assessment Of Wounds Healing In The Region Of Anal Canal In Rats On The Background Of Medicamental Hypocoagulation

Ruzibayev

Ruzmatov

Umarov

2021

tajas

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Purpose of the study: to conduct a morphological study of experimental material to assess the features of wound healing in the anal sphincter area when using the domestic drug “Heprocel” as a hemostatic agent. Material and methods. The study was carried out in the Department of experimental surgery and the department of pathological anatomy of the Republican Specialized Scientific and Practical Medical Center for Surgery named after Academician V. Vakhidov. The state of experimental models of wounds with the application of a hemostatic agent in the form of a gel was studied. The experiments were carried out on 72 white male rats weighing 210-250 g. Two series of 36 animals each were produced. All animals were divided into groups: norm - experiment in the absence of drug hypocoagulation; control - an experiment with intravenous heparin to achieve drug hypocoagulation; experience - an experiment with intravenous administration of heparin to achieve drug hypocoagulation using an application on a model of a skin wound and a dissected anal sphincter of the hemostatic agent "Heprocel". Results. Morphological differences in the process of wound healing were most pronounced after 3 days of the study. In the control group of animals with hemostasis using an electrocoagulator, necrotic and exudative processes of inflammation in the stratified squamous epithelium and mucous membrane of the glands in the anal region were evident. In the experimental group, on the 3-5th day of the experiment, the proliferative process of inflammation predominated morphologically. A special feature is that the hemostatic gel is absorbed into the wound, forming a thin uniform layer. On the 10th day of the experiment, the above difference became more obvious. In the control group, chaotic squamous epithelial cells and fibroblasts were formed. The fibrin-necrotic layer is preserved. Focal infiltration of macrophages-lymphocytes was observed. In the experimental group, the intestinal layers began to change. In the area of the surgical incision, the hemostatic layer is preserved; in this area, the growth of thin fibrous connective tissue is observed. Differentiation and transformation of cells led to the regeneration of the epithelial layer and parakeratosis of the flat cell. Signs of complete remodeling were evident over a long period of time, such as 14 days. Conclusion. The use of a hemostatic agent in the form of a gel provides not only an increase in the processes of local hemostasis, but a decrease in the activity of inflammatory reactions and infection, as well as the risk of developing post-traumatic cicatricial deformity of the anus.

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Partial Stapled Hemorrhoidopexy Versus Circumferential Stapled Hemorrhoidopexy for Grade III to IV Prolapsing Hemorrhoids: A Randomized, Noninferiority Trial

Cited by 22 publications

References 31 publications

Perirectal Hematoma and Intra-Abdominal Bleeding after Stapled Hemorrhoidopexy and STARR—A Proposal for a Decision-Making Algorithm

Perirectal Hematoma and Intra-Abdominal Bleeding after Stapled Hemorrhoidopexy and STARR—A Proposal for a Decision-Making Algorithm

Evacuatory Dysfunction after Stapled Hemorrhoidopexy: A Case Report of Rectal Pocket Syndrome

Morphological Assessment Of Wounds Healing In The Region Of Anal Canal In Rats On The Background Of Medicamental Hypocoagulation

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