Tissue selecting technique mega-window stapler combined with anal canal epithelial preservation operation for the treatment of severe prolapsed hemorrhoids

Abstract

Introduction: Hemorrhoidal disease is one of the most common and frequently occurring benign anorectal disorders, presented with bleeding and prolapsed, and surgery is the main and effective method for severe prolapsed hemorrhoids. Yet, the recurrence rate after procedure for prolapse and hemorrhoids (PPH) is significantly higher. To reduce the recurrence rate and protect the anus function, we try to carry out a randomized, controlled, prospective study to compare the efficacy and recurrence rate of tissue selecting technique (TST) with mega-window stapler (TST-MS) combined with anal canal epithelial preservation operation and PPH combined with external hemorrhoidectomy and inferior internal hemorrhoid ligation operation for the treatment of severe prolapsed hemorrhoids. Methods: This study is a single-center, evaluator-blinded, randomized, controlled clinical trial. Participants meet the inclusion and exclusion criteria in this RCT will be randomly divided into treatment group (TST-MS combined with anal canal epithelial preservation operation group) and control group (PPH combined with external hemorrhoidectomy and inferior internal hemorrhoid ligation operation) in a 1:1 ratio according to a computer-generated randomization list. The outcomes of recurrence, anal function, intraoperative variables, and postoperative complications will be recorded at different follow-ups. Conclusion: The findings of the study will help to explore the efficacy and recurrence rate of TST-MS combined with anal canal epithelial preservation operation on the treatment of severe prolapsed hemorrhoids. Trial registration: This study protocol was registered in open science framework (OSF). (Registration number: DOI 10.17605 / OSF.IO / 4JYNF).

ENSEAL® Hemorrhoidectomy, a Novel Technique, Versus Conventional Open Method for the Management of Grade III and IV Hemorrhoids

“…Hemorrhoidal illness is one of the most prevalent benign anorectal conditions, characterized by bleeding and prolapse. According to research, the prevalence among adults is very high [ 1 ]. The global prevalence of hemorrhoids is reported to be 4.4%, with a peak incidence between the ages of 45 and 65.…”

Outcomes of Modified Tissue Selection Therapy Stapler in the Treatment of Prolapsing Hemorrhoids

“…The experience of clinical observation and medical research indicates that surgical resection combined with other therapeutic methods should be given priority for the treatment of grade III–IV mixed prolapsing hemorrhoids, although debate exists as to which of the multitudinous surgical procedures is the most clinically effective ( 23 ). Pata et al ( 24 ) described the two directions of surgical treatments for hemorrhoids in the first 20 years of the 2000s: modified traditional techniques and minimally invasive techniques.…”

Evaluation of the clinical efficacy and safety of TST33 mega hemorrhoidectomy for severe prolapsed hemorrhoids

“…This study also found that 7 d after the operation, the degree of perianal edema in Group A was lower than that in Group B, suggesting that TST33 mega stapler hemorrhoid mucosal resection in the treatment of severe prolapsed hemorrhoids for postoperative perianal edema was reduced to some extent, and two surgical methods for the treatment of severe prolapsed hemorrhoids can improve anal function. TST33 mega stapler hemorrhoid mucosal resection reduces the number of anastomotic nails implanted and reduces the anal bulge, thus protecting anal contraction defecation functions[ 16 , 17 ].…”