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Sergio Eduardo Alonso Araujo, Lucas de Araujo Horcel, Victor Edmond Seid, Alexandre Bruno Bertoncini, Sidney Klajner
Background: Stapled hemorrhoidopexy is associated with less postoperative pain and faster recovery. However, it may be associated with a greater risk of symptomatic recurrence. We hypothesized that undertaking a limited surgical excision of hemorrhoid disease after stapling may be a valid approach for selected patients. Aim: To compare long-term results after stapled hemorrhoidopexy with and without complementation with closed excisional technique. Method: In a retrospective uni-institutional cohort study, sixty-five (29 men) patients underwent stapled hemorrhoidopexy and 21 (13 men) underwent stapled hemorrhoidopexy with excision...
July 2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Paul A Lehur, Anne S Didnée, Jean-Luc Faucheron, Guillaume Meurette, Philippe Zerbib, Laurent Siproudhis, Béatrice Vinson-Bonnet, Anne Dubois, Christine Casa, Jean-Benoit Hardouin, Isabelle Durand-Zaleski
OBJECTIVE: To compare Doppler-guided hemorrhoidal artery ligation (DGHAL) with circular stapled hemorrhoidopexy (SH) in the treatment of grade II/III hemorrhoidal disease (HD). BACKGROUND: DGHAL is a treatment option for symptomatic HD; existing studies report limited risk and satisfactory outcomes. DGHAL has never before been compared with SH in a large-scale multi-institutional randomized clinical trial. METHODS: Three hundred ninety-three grade II/III HD patients recruited in 22 centers from 2010 to 2013 were randomized to DGHAL (n = 197) or SH (n = 196)...
November 2016: Annals of Surgery
S Leardi, B Pessia, M Mascio, F Piccione, M Schietroma, R Pietroletti
INTRODUCTION: The stapled hemorrhoidopexy (SH) and the Doppler-guided transanal hemorrhoidal dearterialization (DG-THD) are minimally invasive procedures for the surgical treatment of hemorrhoids. This study aims to verify the efficacy of the DG-THD versus the SH in the treatment of third-degree hemorrhoids. METHOD: One hundred consecutive patients were causally allocated to either procedure, obtaining two groups of 50 pts. A clinical examination was performed at 3, 7, 15, and 30 days after the operation...
September 6, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Peeters Karen, Bronckaers Marc, Hendrickx Tom
BACKGROUND: A retrospective analysis was performed to assess differences between three devices used for stapled hemorrhoidopexy (SH) in terms of early complications and complaints and the volume of excised tissue. MATERIALS AND METHODS: All patients who underwent an elective SH from January 2008 to December 2014 were included. Three different devices were used: the PPH03 stapler (Ethicon EndoSurgery, Diegem, Belgium) and the Chex(TM) CPH32 and CPH34 staplers (Frankenman International Ltd, Hong Kong, China)...
August 18, 2016: Acta Chirurgica Belgica
Seong Dae Lee, Sung Taek Jung, Jae-Bum Lee, Mi Jung Kim, Doo-Seok Lee, Eui-Gon Youk, Do-Sun Kim, Doo-Han Lee
A stapled hemorrhoidopexy (SH) is widely used for treatment of patients with grades III and IV hemorrhoids. The SH is easy to perform, is associated with less pain and allows early return to normal activities. However, complications, whether severe or not, have been reported. Here, we present the case of a female patient with persistent bleeding after a SH. The bleeding was caused by the formation of granulation tissue at the stapler line, diagnosed with sigmoidoscopy, and successfully treated via transanal excision (TAE) under spinal anesthesia...
June 2016: Annals of Coloproctology
M Basile, V Di Resta, E Ranieri
BACKGROUND: Hemorrhoidal disease is a common proctologic disorder. The HemorPex System(®) (HPS) (Angiologica, S. Martino Siccomario PV, Italy) is an innovative surgical technique based on muco-hemorrhoidopexy without Doppler guidance. The aim of this study was to evaluate the efficacy of HPS in on the treatment of grade II and III hemorrhoids. METHODS: One hundred patients with grade II and III hemorrhoidal disease were included in the study and operated on using HPS without Doppler guidance...
June 2016: Techniques in Coloproctology
C R Asteria, J Robert-Yap, G Zufferey, F Colpani, A Pascariello, G Lucchini, B Roche
BACKGROUND: As stapled hemorrhoidopexy (SH) becomes more widely used, we see more patients with chronic postoperative anal pain after this surgery. Its presentation is variable and difficult to treat. The aim of our study was to investigate the impact of chronic anal pain after SH and whether tailored therapy was likely to achieve a favorable outcome. METHODS: We retrospectively analyzed 31 consecutive patients with chronic anal pain who had undergone SH in other hospitals and were referred to our institutions...
May 2016: Techniques in Coloproctology
Marcello Picchio, Ettore Greco, Annalisa Di Filippo, Giuseppe Marino, Francesco Stipa, Erasmo Spaziani
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...
December 2015: Indian Journal of Surgery
Giuliano Reboa, Marco Gipponi, Maurizio Gallo, Giovanni Ciotta, Marco Tarantello, Angelo Caviglia, Antonio Pagliazzo, Luigi Masoni, Giuseppe Caldarelli, Fabio Gaj, Bruno Masci, Andrea Verdi
The clinical chart of 621 patients with III-IV haemorrhoids undergoing Stapled Hemorrhoidopexy (SH) with CPH34 HV in 2012-2014 was consecutively reviewed to assess its safety and efficacy after at least 12 months of follow-up. Mean volume of prolapsectomy was significantly higher (13.0 mL; SD, 1.4) in larger prolapse (9.3 mL; SD, 1.2) (p < 0.001). Residual or recurrent haemorrhoids occurred in 11 of 621 patients (1.8%) and in 12 of 581 patients (1.9%), respectively. Relapse was correlated with higher preoperative Constipation Scoring System (CSS) (p = 0...
2016: Surgery Research and Practice
Peter C Ambe, Dirk R Wassenberg
BACKGROUND: Hemorrhoidal disease is highly prevalent in the western world. Stapled hemorrhoidopexy also known as the procedure for prolapsed hemorrhoids (pph) has been shown to be superior to conventional hemorrhoidectomy with regard to postoperative pain, length of hospital stay and early return to work. Proctitis following stapled hemorrhoidopexy has not been reported previously. Herein, we report our experience with proctitis in patients following stapled hemorrhoidopexy and question if proctitis could be a complication of stapled hemorrhoidopexy...
2015: Patient Safety in Surgery
E Aytac, E Gorgun, H H Erem, M A Abbas, T L Hull, F H Remzi
BACKGROUND: We aimed to compare long-term outcomes and quality of life in patients undergoing circular stapled hemorrhoidopexy to those who had Ferguson hemorrhoidectomy. METHODS: Patients who underwent Ferguson hemorrhoidectomy and circular stapled hemorrhoidopexy between 2000 and 2010 were reviewed. Long-term follow-up was assessed with questionnaires. RESULTS: Two hundred seventeen patients completed the questionnaires. Mean follow-up was longer in the Ferguson hemorrhoidectomy subgroups (7...
October 2015: Techniques in Coloproctology
Varut Lohsiriwat
Hemorrhoids is recognized as one of the most common medical conditions in general population. It is clinically characterized by painless rectal bleeding during defecation with or without prolapsing anal tissue. Generally, hemorrhoids can be divided into two types: internal hemorrhoid and external hemorrhoid. External hemorrhoid usually requires no specific treatment unless it becomes acutely thrombosed or causes patients discomfort. Meanwhile, low-graded internal hemorrhoids can be effectively treated with medication and non-operative measures (such as rubber band ligation and injection sclerotherapy)...
August 21, 2015: World Journal of Gastroenterology: WJG
Claudia Menconi, Bernardina Fabiani, Iacopo Giani, Jacopo Martellucci, Gianluca Toniolo, Gabriele Naldini
BACKGROUND: Persistent anal pain (PAP) after stapled procedures, be it hemorrhoidopexy (PPH) or stapled transanal rectal resection (STARR) may be hardly resolved by medical therapy. The typical objective finding in these patients is the staple line characterized by fixed scar to underlying layers. METHODS: A total of 21 consecutive patients were operated for PAP after stapled procedure. The scarred staple line was excised and detached from layers below, the mucosal continuity reconstructed by single stitches...
January 2016: International Journal of Colorectal Disease
S W Lee, R Niec, N Melnitchouk, T Samdani
AIM: Current surgical options for the treatment of rectal stricture are either technically difficult or result in a high rate of recurrence. We describe the results of a simple and potentially effective technique of transanal stricturoplasty using the Heineke-Mikulicz principle. METHOD: The medical records and a prospectively maintained database of patients with rectal stricture were searched. Those who underwent transanal stricturoplasty for an anorectal stricture from 2007 to 2013 were studied retrospectively...
January 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Arndt Voigtsberger, Lucia Popovicova, Gunter Bauer, Knut Werner, Tina Weitschat-Benser, Sven Petersen
PURPOSE: Since its introduction, stapled hemorrhoidopexy (SHP), the so-called Longo procedure, became a widely accepted treatment option for prolapsing hemorrhoids. Nevertheless, from the early years, concerns grew about the early functional results and potential recurrences. In order to evaluate of SHP with special respect to early defecation disorders und recurrences, our single institute high-volume results were evaluated. METHOD: One thousand one hundred forty-four consecutive patients with SHP for prolapsing hemorrhoids were evaluated in a period from January 2007 to December 2013...
January 2016: International Journal of Colorectal Disease
S Kersting, A Herold, K-P Jung, E Berg
BACKGROUND: Hemorrhoid operations are performed frequently in Germany. After the operation severe complications can occur that require appropriate management. OBJECTIVE: Presentation of current complications and suitable therapeutic options. MATERIAL AND METHODS: Data including operative procedures and complications that have been collected in an electronic online-based survey of all resident, affiliated and private practice German surgeons during the period from 1 December 2009 to 31 January 2010 are presented...
August 2015: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Michele Rubbini, Valerio Tartari
BACKGROUND: Transanal hemorrhoidal dearterialization, although it showed reliability, has not completely removed the issue of postoperative pain. OBJECTIVE: We investigated the causes of postoperative pain and proposed some changes of the technique in order to eliminate it. PATIENTS: One hundred six out of 188 operated patients were considered. Postoperative pain was investigated using a Visual Analogue Score dividing patients into three groups: 0 to 3, 4 to 6, and 7 to 10...
May 2015: International Journal of Colorectal Disease
M Tagliabue, C Cusumano, E S Kechoud, D Paternicò, M Rasini, D Carriero, F P Paladino
No abstract text is available yet for this article.
April 2015: Techniques in Coloproctology
Liesel J Porrett, Jemma K Porrett, Yik-Hong Ho
A systematic review addressing reported complications of stapled hemorrhoidopexy was conducted. Articles were identified via searching OVID and MEDLINE between July 2011 and October 2013. Limitations were placed on the search criteria with articles published from 1998 to 2013 being included in this review. No language restrictions were placed on the search, however foreign language articles were not translated. Two reviewers independently screened the abstracts for relevance and their suitability for inclusion...
January 2015: International Surgery
Yusuf Bilgin, Semih Hot, İlhami Soykan Barlas, Arzu Akan, Yavuz Eryavuz
PURPOSE: In this prospective randomized study, our aim is to compare the short- and long-term results of harmonic scalpel hemorrhoidectomy (HSH) and stapler hemorrhoidopexy (SH) methods in the surgical treatment of Grade III and Grade IV hemorrhoidal disease. METHODS: Ninety-nine consecutive patients diagnosed with Grade III or Grade IV internal hemorrhoidal disease were included in the study. Patients were randomized to HSH (n = 48) or SH (n = 51) treatments...
October 2015: Asian Journal of Surgery
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