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Operationen beim Hämorrhoidalleiden

Indikation und Technik

Operations for hemorrrhoids

Indications and techniques

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Zusammenfassung

Das Hämorrhoidalleiden ist eine der häufigsten Erkrankungen überhaupt, ohne Therapie ist meist mit einer Progredienz des Leidens zu rechnen. Therapeutisch sind konservative Maßnahmen und in den fortgeschrittenen Stadien operative Verfahren Mittel der Wahl. In Deutschland werden 40.000 bis 50.000 Operationen pro Jahr durchgeführt. Mit den heute zur Verfügung stehenden unterschiedlichen Operationstechniken ist das Ziel eine individualisierte Therapie und Indikationsstellung. Damit ist eine hohe Heilungsrate, niedrige Komplikationsrate und hohe Patientenzufriedenheit erreichbar.

Abstract

Haemorrhoidal disease is one of the most common diseases in general and will in most cases progress without therapy. In the therapeutic context the means of choice are conservative therapies and in the advanced stage of the disease operative measures are necessary. In Germany 40,000–50,000 operations are performed each year. Our aim with the currently available various operation techniques is individualized therapy and indications. Thus a high healing rate, low complication rate and high patient satisfaction can be achieved.

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Literatur

  1. Aigner F, Bodner G et al (2004) The superior rectal artery and its branching pattern with regard to its clinical influence on ligation techniques for internal hemorrhoids. Am J Surg 187:102–108

    Article  PubMed  Google Scholar 

  2. Allan A, Samad AJ, Mellon A, Marshall T (2006) Prospective randomised study of urgent haemorrhoidectomy compared with non-operative treatment in the management of prolapsed thrombosed internal haemorrhoids. Colorectal Dis 8:41–45

    Article  CAS  PubMed  Google Scholar 

  3. Avital S, Itah R, Skornick Y, Greenberg R (2011) Outcome of stapled hemorrhoidopexy versus doppler-guided hemorrhoidal artery ligation for grade III hemorrhoids. Tech Coloproctol 15:267–271

    Article  CAS  PubMed  Google Scholar 

  4. Barron J (1963) Office ligation treatment of hemorrhoids. Dis Colon Rectum 6:109–113

    Article  CAS  PubMed  Google Scholar 

  5. Blanchard C (1928) Text-book of ambulant proctology. Medical Success Press, Youngstown, Ohio, S 134

  6. Blond K, Hoff H (1936) Das Hämorrhoidalleiden. Deutike, Leipzig

  7. Broader H, Gunn I, Alexander-Williams J (1974) Evalution of a bulk forming evacuant in the managment of hemorrhoids. Br J Surg 61:142–144

    Article  CAS  PubMed  Google Scholar 

  8. Bronstein M, Issa N, Gutman M et al (2008) Ligation under vision of haemorrhoidal cushions for therapy of bleeding haemorrhoids. Tech Coloproctocol 12:119–122

    Article  CAS  Google Scholar 

  9. Bursics A, Morvay K, Kupcsulik P, Flautner L (2004) Comparison of early and 1-year follow-up results of conventional hemorrhoidectomy and hemorrhoid artery ligation: a randomized study. Int J Colorectal Dis 19:176–180

    Article  PubMed  Google Scholar 

  10. Ferguson JA, Mazier WP, Ganchrow MI, Friend WG (1971) The closed technique of hemorrhoidectomy. Surgery 70:480–484

    CAS  PubMed  Google Scholar 

  11. Forrest N, Mullerat J, Evans C, Middleton S (2010) Doppler-guided haemorrhoidal artery ligation with recto anal repair: a new technique for the treatment of symptomatic haemorrhoids. Int J Colorectal Dis 25:1251–1256

    Article  PubMed  Google Scholar 

  12. Fritsch M, Duschka L, Müller-Lobeck H, Kraemer M (2008) LigaSure® versus BiClamp®: ein Erfahrungsbericht zum Vergleich neuerer Diathermieverfahren bei Hämorrhoidektomien Coloproctology 30:357–364

    Google Scholar 

  13. Giamundo P, Salfi R, Geraci M et al (2011) The hemorrhoid laser procedure technique vs rubber band ligation: a randomized trial comparing 2 mini-invasive treatments for second- and third-degree hemorrhoids. Dis Colon Rectum 54:693–698

    Article  PubMed  Google Scholar 

  14. Giordano P, Gravante G, Sorge R et al (2009) Long-term outcomes of stapled hemorrhoidopexy vs conventional hemorrhoidectomy. Arch Surg 144:266–272

    Article  PubMed  Google Scholar 

  15. Giordano P, Nastro P, Davies A, Gravante G (2011) Prospective evaluation of stapled haemorrhoidopexy versus transanal haemorrhoidal dearterialisation for stage II and III haemorrhoids: three-year outcomes. Tech Coloproctol 15:67–73

    Article  CAS  PubMed  Google Scholar 

  16. Gupta PJ, Kalaskar S, Taori S, Heda PS (2011) Doppler-guided hemorrhoidal artery ligation does not offer any advantage over suture ligation of grade 3 symptomatic Hemorrhoids. Tech Coloproctol 15:439–444

    Article  CAS  PubMed  Google Scholar 

  17. Herold A, Breitkopf C, Furtwängler et al (2008) Für die Dt. Gesellschaft für Koloproktologie AWMF-Leitlinie Hämorrhoidalleiden, Leitlinie Nr. 081–007 http://www.awmf.org/uploads/tx_szleitlinien/081–007e_S1_Haemorrhoidalleiden_07- 2008_07–2012.pdf

  18. Herold A (2011) Hämorrhoiden. In: Brühl W, Herold A, Wienert V (Hrsg) Aktuelle Proktologie. 4. Aufl. UNI-MED Science, Bremen

  19. Jayaraman S, Colquhoun P, Malthaner R (2007) Stapled hemorrhoidopexy is associated with a higher long-term recurrence rate of internal hemorrhoids compared with conventional excisional hemorrhoid surgery. Dis Colon Rectum 50:1297–1305

    Article  PubMed  Google Scholar 

  20. Jongen J, Peleikis HG (2006) Doppler-guided hemorrhoidal artery ligation: an alternative to hemorrhoidectomy. Dis Colon Rectum 49:1082

    Article  PubMed  Google Scholar 

  21. Lan P, Wu X, Zhou X, Wang J, Zhang L (2006) The safety and efficacy of stapled hemorrhoidectomy in the treatment of hemorrhoids: a systematic review and meta-analysis of ten randomized control trials. Int J Colorectal Dis 21:172–178

    Article  PubMed  Google Scholar 

  22. MacRae H, McLeod R (1995) Comparison of hemorrhoidal treatment modalities: a meta-analysis. Dis Colon Rectum 38: 687–694

    Article  CAS  PubMed  Google Scholar 

  23. Milligan ET, Morgan CN, Lond LE (1937) Surgical anatomy of the anal canal, and the operative treatment of haemorrhoids. Lancet II:1119–1124

    Article  Google Scholar 

  24. Milito G, Cadeddu F, Muzi M et al (2010) Haemorrhoidectomy with Ligasure TM vs. conventional excisional techniques: meta-analysis of randomized controlled trials. Colorectal Dis 12:85–93

    Article  CAS  PubMed  Google Scholar 

  25. Morinaga K, Hasuda K et al (1995) A novel therapy for internal hemorrhoids: Ligation of the hemorrhoidal artery with a newly devised instrument (Moricorn) in conjunction with a Doppler flowmeter. Am J Gastroenterol 90:610–613

    CAS  PubMed  Google Scholar 

  26. Parks AG (1956) The surgical treatment of haemorrhoids. Br J Surg 43:337–351

    Article  CAS  PubMed  Google Scholar 

  27. Rivadeneira, D, Steele S, Ternent C et al (2011) Practice parameters for the management of hemorrhoids (Revised 2010). Dis Colon Rectum 54:1059–1064

    Article  PubMed  Google Scholar 

  28. Shao WJ, Li GC, Zhang Z et al (2008) Systematic review and meta-analysis of randomized controlled trials comparing stapled haemorrhoidopexy with conventional haemorrhoidectomy. Br J Surg 95:147–160

    Article  PubMed  Google Scholar 

  29. Stelzner F, Staubesand J, Machleidt H (1962) Das corpus cavernosum recti – die Grundlage der inneren Haemorrhoiden. Langenbeck‘s Arch Chir 299:302–312

    Google Scholar 

  30. Tjandra J (2007) Systematic review on the procedure for prolapse and hemorrhoids (stapled hemorrhoidopexy). Dis Colon Rectum 50:878–892

    Article  PubMed  Google Scholar 

  31. Walker A, Leicester R, Nicholls R (1990) A prospective study of infrared coagulation, injection and rubber band ligation in the treatment of hemorrhoids. Int J Colorectal Dis 5:113–116

    Article  CAS  PubMed  Google Scholar 

  32. Joos AK, Herold A (2010) Hämorrhoidalleiden. Gastroenterologe 5:326–335

    Article  Google Scholar 

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  1. End- und Dickdarm-Zentrum Mannheim, Bismarckplatz 1, 68165, Mannheim, Deutschland

    A. Herold, A. Joos & D. Bussen

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  1. A. Herold
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  2. A. Joos
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  3. D. Bussen
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Correspondence to A. Herold.

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Herold, A., Joos, A. & Bussen, D. Operationen beim Hämorrhoidalleiden. Chirurg 83, 1040–1048 (2012). https://doi.org/10.1007/s00104-012-2294-x

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