Prospective randomized multicentre trial comparing stapled with open haemorrhoidectomy

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

doi:10.1046/j.0007-1323.2001.01772.x

Cited by 291 publications

(356 citation statements)

References 18 publications

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“…This findings supports the report by Tjandra JJ et al, Laughlan K et al [12,14] Stapled group returned to their daily activities much faster than classical hemorrhoidectomy patients. Ganio E et al have opined similar finding in their publication [5].…”

Section: Cost Effectivenesssupporting

confidence: 53%

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Stapled Hemorrhoidopexy Versus Classical Hemorrhoidectomy – A Prospective Comparative Study with 3 Years Follow-up

2017

IJCRR

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Hemorrhoids are the common benign anal problems in rural India and usually the patients present to the surgical outpatient department at late stage. This prospective randomized clinical trial is aimed to compare the results of classical versus stapled hemorrhoidopexy for treatment of third and fourth degree hemorrhoids.Objective: We report our experience on surgical treatment focusing on postoperative pain, complications and days to return normal activities after the procedure Methods: 106 patients admitted for surgical treatment with class III/IV hemorrhoids from June 2011 to May 2013 were randomly assigned to classical (n=53) or stapled hemorrhoidopexy (n=53).The outcomes included in form of post operative pain, procedure time, number of days taken to return to work, post-operative bleeding, acute urinary retention, need of dressings, and anal stricture were compared. The patients were followed up to 3 years for recurrence of symptoms.Results: Stapled procedure group had less postoperative pain, earlier return to normal activity and less recurrence after 3 years of the study. There is no need of Seitz bath after stapled procedure Conclusion: Stapled hemorrhoidopexy is an effective alternative treatment for third and fourth degree hemorrhoids with significant advantages for patients compared with traditional open hemorrhoidectomy.

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Section: Cost Effectivenesssupporting

confidence: 53%

“…By conventional criteria, this difference is considered to be extremely statistically significant. A series of studies shows duration of surgery is significantly low in stapled group [4,5,6].…”

Section: Cost Effectivenessmentioning

confidence: 99%

Stapled Hemorrhoidopexy Versus Classical Hemorrhoidectomy – A Prospective Comparative Study with 3 Years Follow-up

2017

IJCRR

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“…However, no difference was reported to be with excisional techniques in terms of postoperative complications and recurrences. [2][3][4][5][6] Nonetheless, studies reporting serious complications such as rectal perforation, chronic anal pain, anal stenosis, sepsis, and hematoma after Longo's method are also present. [7][8][9][10][11][12] The aim in our study was to present results of 3 rd and 4 th degree hemorrhoid patients in whom we performed stapled hemorrhoidopexy and to discuss in accompaniment of the literature.…”

Section: Introductionmentioning

confidence: 99%

Stapled hemorrhoidopexy: clinical results for 65 cases

Pergel

Yücel²,

Aydın³

et al. 2012

J Clin Exp Invest

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ÖZETAmaç: Hemoroidal hastalık sebebiyle stapler hemoroidopeksi uyguladığımız hastalarımızın sonuçlarını sunmak ve literatür eşliğinde tartışmak. Gereç ve yöntem:Ocak 2009-Nisan 2011 tarihleri arasında 3-4. derece hemoroidal hastalık tanısı konan ve Longo yöntemiyle hemoroidopeksi uygulanan hastalar çalışmaya dahil edildi. Tüm veriler prospektif toplanıp retrospektif olarak incelendi. Hastalar; demografik özellikler, başvuru sırasındaki şikayetler, ameliyat sonrası komplikasyonlar açısından değerlendirildi. Bulgular:Toplam 65 hastadan 43 (% 66)'ü erkek, 22 (% 34)'si kadındı. Ortalama yaş 38±11.9 (23-76) yıl idi. Olguların en sık başvuru şikayetleri sıklık sırasına göre kanama, şişlik, kaşıntı, ağrı, kabızlık şeklinde idi. Elli sekiz (% 89) hastada 3. derece, 7 (%11) hastada 4. derece hemoroid mevcuttu. Ortalama ameliyat süresi 37.6±8.1(24-55) dakika, ortalama yatış süresi 27±7.8 (20-76) saat idi. Toplam 17 (% 26) hastada bir ya da daha fazla komplikasyon gelişti. Komplikasyon olarak 13 (% 20) hastada kanama, 6 (%9)'sında ağrı, 2 (% 3)'sinde idrar retansiyonu, 3 (% 5)'ünde tenezm, 1 (% 2)'inde eksternal hemoroidal tromboz, 4 (%6)'ünde ise nüks saptandı. Sonuç:Stapler hemoroidopekside ağrının az ve iyileşme sürecinin hızlı olması nedeniyle hastalar günlük aktivitelerine erken dönebilmektedirler. Bu yöntemin başarısında uygun hasta seçimi ve tekniğin doğru uygulanmasının önemli olduğunu düşünmekteyiz. Özellikle 3.derece hemoroidal hastalıkta Longo tekniği klasik yöntemlere alternatif olarak önerilebilir.Anahtar kelimeler: Hemoroidal hastalık, stapler hemoroidopeksi, Longo yöntemi ABSTRACT Objectives: To present results of our patients underwent stapled hemorrhoidopexy due to hemorrhoidal disease and discuss in accompaniment with the literature. Material and methods:The patients, who diagnosed by 3 rd -4 th degree hemorrhoidal disease and underwent hemorrhoidopexy with Longo method between January, 2009 and April, 2011, were included. All data were prospectively collected and retrospectively examined. The patients were evaluated in terms of demographic properties, complaints on admission, and postoperative complications.Results: Forty-three (66%) of 65 patients were male, 22 (34%) were female. The mean age was 38±11.9 (range:23-76) years. The most frequent complaints were bleeding, swelling, itching, pain, constipation respectively. Third degree hemorrhoid was present in fifty-eight (89%) patients, 4 th degree hemorrhoid was in 7 (11%) patients. The mean operation duration was 37.6±8.1(range:24-55) minutes, the mean hospitalization duration was 27±7.8 (range:20-76) hours. One or more complication developed in total 17 (26%) patients. As complication, bleeding was determined in 13 (20%) patients, pain was in 6 (9%), urinary retention was in 2 (3%), tenesmus was in 3 (5%), external hemorrhoidal thrombosis was in 1 (2%), and recurrence was in 4 (6%). Conclusions:The patients can return their daily activities early with stapled hemorrhoidopexy because of less pain and quick recovery period. We consider that appropriate p...

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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%

“…Bleeding in the immediate postoperative period is almost always due to inadequate intraoperative hemostasis. In the existing literature, this complication occurs in 4 to 25 % of cases [41][42][43][44][45][46][47][48]. Bleeding predominantly affects patients with fourth-degree hemorrhoids [49,50].…”

Section: Complicationsmentioning

confidence: 99%

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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Prospective randomized multicentre trial comparing stapled with open haemorrhoidectomy

Abstract: Stapled haemorrhoidectomy is as effective as conventional haemorrhoidectomy. Reduced postoperative pain, shorter hospital stay and a trend toward earlier return to work suggest short-term advantages for the stapled technique.

Cited by 291 publications

References 18 publications

Stapled Hemorrhoidopexy Versus Classical Hemorrhoidectomy – A Prospective Comparative Study with 3 Years Follow-up

Stapled Hemorrhoidopexy Versus Classical Hemorrhoidectomy – A Prospective Comparative Study with 3 Years Follow-up

Stapled hemorrhoidopexy: clinical results for 65 cases

Clinical Outcome Following Hemorrhoid Surgery: a Narrative Review

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