Randomized controlled trial to compare the early and mid-term results of stapled versus open hemorrhoidectomy

Bikhchandani, Jai; Agarwal, Priti; Kant, Ravi; Malik, Vishwas

doi:10.1016/j.amjsurg.2004.03.014

Cited by 103 publications

(134 citation statements)

References 20 publications

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“…Additionally, SH procedure also resulted in shorter hospital stay, early recovery, and time to resume normal activities. The other studies also have reported shorter hospital stay post SH procedure [18][19][20][21][22]. Our case series also showed similar findings.…”

Section: Discussionsupporting

confidence: 90%

“…Other studies observed reduced post-operative pain [19,25] and also, in systematic reviews and meta-analyses relief of postoperative pain was observed after SH procedure [10,11,13]. Similarly, we have observed 96 % pain relief at 1 year follow up.…”

Section: Discussionsupporting

confidence: 85%

“…The clinical effectiveness have been proved by showing minimal post-operative pain, shorter hospital stay, early to resume the work, shorter operative time, and acceptable safety profile [10][11][12][13][14][15][16]. Many of the studies [18][19][20][21][22] reported the average length of operation time was around 25 minutes, highlighting the saving time as compared to conventional surgeries. Additionally, SH procedure also resulted in shorter hospital stay, early recovery, and time to resume normal activities.…”

Section: Discussionmentioning

confidence: 99%

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Stapled Hemorrhoidopexy and Long Term Outcomes - A Single Center Experience of 3130 Cases at Healing Hands Clinic, India

Porwal¹

2017

GHOA

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Introduction: Stapled Hemorrhoidopexy (SH) is relatively less painful surgery and treatment of choice for grade III and IV internal hemorrhoids. The current study reveals the long term effectiveness of modified Longo technique in 3130 patients treated at a single center. Methods:All the patients with complaints of hemorrhoids visited Healing Hands Clinic, Pune during study period were evaluated. Patients diagnosed with grade III and grade IV were operated with modified Longo technique Stapled Hemorrhoidopexy .Follow up was done after 15 days, 1month, 3months & 12months. Telephonic follow up was done in patients who were not available. The minimum follow up period was 1 years and maximum 7 years. The data evaluated for pre-operative and post-operative symptoms improvements, resumption to normal activity, treatment satisfaction and recurrence rate and quality of life. Results:The mean surgery time and hospitalization duration were 20 minutes and 18 hours respectively. Post-operatively mild pain was reported by 57.53% (n=1801) patients, by 19.14% (n=599) on day 15, 4.89% (n=153) at 3 Months and no patient had pain at the end of 1 year. Patient's satisfaction on Day 3, 57.82% (n=1810) patient were very satisfied, 33.04% (n= 1034) were moderately satisfied and 9.14 % (n=286) were not satisfied with the treatment. The immediate complications (all mild) included urinary retention (5.69%, n=178), difficult defecation (11.69%, n=366), anal fissure (3.83% (n=120), postoperative bleeding 1.05%, (n=33), and anal stenosis 0.93 %( n=29). All patients returned to normal work / activities in an average of 5 days. There was significant improvement in overall perception of World Health Organization-Quality of life and social, physical, psychological domains after surgery. The recurrence rate at 1 year was 0.23%. Conclusion:Modified Longo Technique of Stapled hemorrhoidopexy is associated with low complications rate, minimal post-operative pain and negligible recurrence rate.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

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Stapled Hemorrhoidopexy and Long Term Outcomes - A Single Center Experience of 3130 Cases at Healing Hands Clinic, India

Porwal¹

2017

GHOA

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“…The stapled procedure was performed in lithotomy position under general anesthesia, according to the technique described by Longo [13], with slight modifications [15]. Using the purse string anoscope in the Ethicon Endosurgery stapler set, a circumferential purse string suture with 2-0 polypropylene (on a 30-mm curved, round-bodied needle) was taken starting at 3 o'clock, at least 3 cm proximal to the dentate line.…”

Section: Surgical Technique Of Stapled Hemorrhoidectomymentioning

confidence: 99%

Stapled Hemorrhoidectomy; Results of a Prospective Clinical Trial in Saudi Arabia

Guraya

Khairy²

2013

JCDR

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Objectives: This study was designed to evaluate the effectiveness of stapled hemorrhoidectomy (SH) in terms of cure of the symptoms and post-operative pain control. Material and Methods:In this prospective clinical study, SH (Ethicon Endo-surgery, Cincinnati, OH) was performed for all patients with grade III and grade IV hemorrhoids, presenting to the surgical clinics of Ohud and Meeqat Hospitals Almadinah Almunawwarah Saudi Arabia. The results of SH were evaluated by a questionnaire focusing on the relief of symptoms, severity of post operative pain, and complications of SH.Results: Thirty patients (21 males and 9 females); with a mean age of 39.6 years were recruited in this study. Twenty six (86%) patients had grade III and 4 (14%) presented with grade IV hemorrhoids. Perianal prolapse was the most frequent presentation reported in 23 (76%). Mean operating time was 21.7 minutes (range; 17-36 minutes) whereas mean hospital stay was 1.9 days. Post-operative pain was tolerable (nonpersistent) in 28 (93%) cases whereas 2 (7%) experienced mild pain requiring additional analgesia. Urinary retention was the most common complication found in 5 (16%) patients. All patients were cured of the hemorrhoids Conclusion: SH is a safe, rapid, and convenient surgical remedy for grade III and grade IV hemorrhoids with low rate of complications, minimal postoepative pain, and early discharge from the hospital.

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“…Intraop/immediate postoperative minor bleed and urinary retention is more common in classical hemorhoidectomy group compare to stapled, in more than 95% of cases complete circumferential donut of the stapler line achieved at the end of procedure [8,9,11].…”

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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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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Randomized controlled trial to compare the early and mid-term results of stapled versus open hemorrhoidectomy

Cited by 103 publications

References 20 publications

Stapled Hemorrhoidopexy and Long Term Outcomes - A Single Center Experience of 3130 Cases at Healing Hands Clinic, India

Stapled Hemorrhoidopexy and Long Term Outcomes - A Single Center Experience of 3130 Cases at Healing Hands Clinic, India

Stapled Hemorrhoidectomy; Results of a Prospective Clinical Trial in Saudi Arabia

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

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