Skip to main content
Erschienen in: Surgery Today 9/2012

01.09.2012 | Original Article

Partial stapled hemorrhoidopexy: a minimally invasive technique for hemorrhoids

verfasst von: Hong-Cheng Lin, Qiu-Lan He, Dong-Lin Ren, Hui Peng, Shang-Kui Xie, Dan Su, Xiao-Xue Wang

Erschienen in: Surgery Today | Ausgabe 9/2012

Einloggen, um Zugang zu erhalten

Abstract

Purpose

This study was designed to assess the safety, efficacy, and postoperative outcomes of partial stapled hemorrhoidopexy (PSH).

Methods

A prospective study was conducted between February and March 2010. PSH was performed with single-window anoscopes for single isolated hemorrhoids, bi-window anoscopes for two isolated hemorrhoids, and tri-window anoscopes for three isolated hemorrhoids or circumferential hemorrhoids. The data pertaining to demographics, preoperative characteristics and postoperative outcomes were collected and analyzed.

Results

Forty-four eligible patients underwent PSH. Single-window anoscopes were used in 2 patients, and bi- and tri-window anoscopes in 6 and 36 patients. The blood loss in patients with single-window, bi-window, and tri-window anoscopes was 6.0 ml (range 5.0–7.0 ml), 5.0 ml (range 5.0–6.5 ml), and 5.0 ml (4.5–14.5 ml) (P = 0.332). The mean postoperative visual analog scale score for pain was 3 (range, 1–4), 2 (range 1–4), 3 (range 2–6), 1 (range 0–3), 1 (range 0–2) and 2 (range 2–4) at 12 h, days 1, 2, 3, and 7, and at first defecation. The rate of urgency was 9.1%. No patients developed anal incontinence or stenosis. The 1-year recurrence rate of prolapsing hemorrhoids was 2.3%.

Conclusions

Partial stapled hemorrhoidopexy appears to be a safe and effective technique for grade III–IV hemorrhoids. Encouragingly, PSH is associated with mild postoperative pain, few urgency episodes, and no stenosis or anal incontinence.
Literatur
1.
Zurück zum Zitat Bleday R, Pena JP, Rothenberger DA, Goldberg SM, Buls JG. Symptomatic hemorrhoids: current incidence and complications of operative surgery. Dis Colon Rectum. 1992;35:477–81.PubMedCrossRef Bleday R, Pena JP, Rothenberger DA, Goldberg SM, Buls JG. Symptomatic hemorrhoids: current incidence and complications of operative surgery. Dis Colon Rectum. 1992;35:477–81.PubMedCrossRef
3.
Zurück zum Zitat Wolff BG, Culp CE. The Whitehead hemorrhoidectomy. An unjustly maligned procedure. Dis Colon Rectum. 1988;31:587–90.PubMedCrossRef Wolff BG, Culp CE. The Whitehead hemorrhoidectomy. An unjustly maligned procedure. Dis Colon Rectum. 1988;31:587–90.PubMedCrossRef
4.
Zurück zum Zitat Ommer A, Wenger FA, Rolfs T, Walz MK. Continence disorders after anal surgery—a relevant problem? Int J Colorectal Dis. 2008;23:1023–31.PubMedCrossRef Ommer A, Wenger FA, Rolfs T, Walz MK. Continence disorders after anal surgery—a relevant problem? Int J Colorectal Dis. 2008;23:1023–31.PubMedCrossRef
5.
Zurück zum Zitat Milligan ETC, Morgan CN, Jones LE, Lond MB, Officer R, Melb BS. Surgical anatomy of the anal canal and the operative treatment of hemorrhoids. Lancet. 1937;2:1119.CrossRef Milligan ETC, Morgan CN, Jones LE, Lond MB, Officer R, Melb BS. Surgical anatomy of the anal canal and the operative treatment of hemorrhoids. Lancet. 1937;2:1119.CrossRef
6.
Zurück zum Zitat Khubchandani IT. Operative hemorrhoidectomy. Surg Clin N Am. 1988;68:1411–6.PubMed Khubchandani IT. Operative hemorrhoidectomy. Surg Clin N Am. 1988;68:1411–6.PubMed
7.
Zurück zum Zitat Longo A. Treatment of hemorrhoidal disease by reduction of mucosa and hemorrhoidal prolapse with a circular suturing device: a new procedure. In: Proceedings of the 6th World Congress of Endoscopic Surgery. Bologna: Monduzzi Editore, 1998:777–84. Longo A. Treatment of hemorrhoidal disease by reduction of mucosa and hemorrhoidal prolapse with a circular suturing device: a new procedure. In: Proceedings of the 6th World Congress of Endoscopic Surgery. Bologna: Monduzzi Editore, 1998:777–84.
8.
Zurück zum Zitat Shao WJ, Li GC, Zhang ZH, Yang BL, Sun GD, Chen YQ. Systematic review and meta-analysis of randomized controlled trials comparing stapled haemorrhoidopexy with conventional haemorrhoidectomy. Br J Surg. 2008;95:147–60.PubMedCrossRef Shao WJ, Li GC, Zhang ZH, Yang BL, Sun GD, Chen YQ. Systematic review and meta-analysis of randomized controlled trials comparing stapled haemorrhoidopexy with conventional haemorrhoidectomy. Br J Surg. 2008;95:147–60.PubMedCrossRef
9.
Zurück zum Zitat Laughlan K, Jayne DG, Jackson D, Rupprecht F, Ribaric G. Stapled haemorrhoidopexy compared to Milligan-Morgan and Ferguson haemorrhoidectomy: a systematic review. Int J Colorectal Dis. 2009;24:335–44.PubMedCrossRef Laughlan K, Jayne DG, Jackson D, Rupprecht F, Ribaric G. Stapled haemorrhoidopexy compared to Milligan-Morgan and Ferguson haemorrhoidectomy: a systematic review. Int J Colorectal Dis. 2009;24:335–44.PubMedCrossRef
10.
Zurück zum Zitat Hachiro Y, Kunimoto M, Abe T, Kitada M, Ebisawa Y. Aluminum potassium sulfate and tannic acid (ALTA) injection as the mainstay of treatment for internal hemorrhoids. Surg Today. 2011;41:806–9.PubMedCrossRef Hachiro Y, Kunimoto M, Abe T, Kitada M, Ebisawa Y. Aluminum potassium sulfate and tannic acid (ALTA) injection as the mainstay of treatment for internal hemorrhoids. Surg Today. 2011;41:806–9.PubMedCrossRef
11.
Zurück zum Zitat Fueglistaler P, Guenin MO, Montali I, Kern B, Peterli R, von Flüe M, et al. Long-term results after stapled hemorrhoidopexy: high patient satisfaction despite frequent postoperative symptoms. Dis Colon Rectum. 2007;50:204–12.PubMedCrossRef Fueglistaler P, Guenin MO, Montali I, Kern B, Peterli R, von Flüe M, et al. Long-term results after stapled hemorrhoidopexy: high patient satisfaction despite frequent postoperative symptoms. Dis Colon Rectum. 2007;50:204–12.PubMedCrossRef
12.
Zurück zum Zitat Brisinda G, Vanella S, Cadeddu F, Marniga G, Mazzeo P, Brandara F, et al. Surgical treatment of anal stenosis. World J Gastroenterol. 2009;15:1921–8.PubMedCrossRef Brisinda G, Vanella S, Cadeddu F, Marniga G, Mazzeo P, Brandara F, et al. Surgical treatment of anal stenosis. World J Gastroenterol. 2009;15:1921–8.PubMedCrossRef
13.
14.
Zurück zum Zitat Z’graggen K, Maurer CA, Birrer S, Giachino D, Kern B, Büchler MW. A new surgical concept for rectal replacement after low anterior resection. Ann Surg. 2001;234:780–7.PubMedCrossRef Z’graggen K, Maurer CA, Birrer S, Giachino D, Kern B, Büchler MW. A new surgical concept for rectal replacement after low anterior resection. Ann Surg. 2001;234:780–7.PubMedCrossRef
17.
Zurück zum Zitat Cheetham MJ, Mortensen NJ, Nystrom PO, Kamm MA, Phillips RK. Persistent pain and faecal urgency after stapled haemorrhoidectomy. Lancet. 2000;356:730–3.PubMedCrossRef Cheetham MJ, Mortensen NJ, Nystrom PO, Kamm MA, Phillips RK. Persistent pain and faecal urgency after stapled haemorrhoidectomy. Lancet. 2000;356:730–3.PubMedCrossRef
18.
Zurück zum Zitat Gao XH, Fu CG, Nabieu PF. Residual skin tags following procedure for prolapse and hemorrhoids: differentiation from recurrence. World J Surg. 2010;34:344–52.PubMedCrossRef Gao XH, Fu CG, Nabieu PF. Residual skin tags following procedure for prolapse and hemorrhoids: differentiation from recurrence. World J Surg. 2010;34:344–52.PubMedCrossRef
19.
Zurück zum Zitat Gerjy R, Nyström PO. Excision of residual skin tags during stapled anopexy does not increase postoperative pain. Colorectal Dis. 2007;9:754–7.PubMedCrossRef Gerjy R, Nyström PO. Excision of residual skin tags during stapled anopexy does not increase postoperative pain. Colorectal Dis. 2007;9:754–7.PubMedCrossRef
20.
Zurück zum Zitat Gravié JF, Lehur PA, Huten N, Papillon M, Fantoli M, Descottes B, et al. Stapled hemorrhoidopexy versus Milligan-Morgan hemorrhoidectomy: a prospective, randomized, multicenter trial with 2-year postoperative follow up. Ann Surg. 2005;242:29–35.PubMedCrossRef Gravié JF, Lehur PA, Huten N, Papillon M, Fantoli M, Descottes B, et al. Stapled hemorrhoidopexy versus Milligan-Morgan hemorrhoidectomy: a prospective, randomized, multicenter trial with 2-year postoperative follow up. Ann Surg. 2005;242:29–35.PubMedCrossRef
21.
Zurück zum Zitat Mlakar B, Kosorok P. Complications and results after stapled haemorrhoidopexy as a day surgical procedure. Tech Coloproctol. 2003;7:164–8.PubMedCrossRef Mlakar B, Kosorok P. Complications and results after stapled haemorrhoidopexy as a day surgical procedure. Tech Coloproctol. 2003;7:164–8.PubMedCrossRef
22.
Zurück zum Zitat Yao LQ, Zhong YS, Xu JM, Zhou PH, Xu MD, Song LJ, et al. Rectal stenosis following procedure for prolapse and hemorrhoids. Zhonghua Wai Ke Za Zhi. 2006;44:897–9.PubMed Yao LQ, Zhong YS, Xu JM, Zhou PH, Xu MD, Song LJ, et al. Rectal stenosis following procedure for prolapse and hemorrhoids. Zhonghua Wai Ke Za Zhi. 2006;44:897–9.PubMed
23.
Zurück zum Zitat Brisinda G. How to treat haemorrhoids. Prevention is best; haemorrhoidectomy needs skilled operators. BMJ. 2000;321:582–3.PubMedCrossRef Brisinda G. How to treat haemorrhoids. Prevention is best; haemorrhoidectomy needs skilled operators. BMJ. 2000;321:582–3.PubMedCrossRef
Metadaten
Titel
Partial stapled hemorrhoidopexy: a minimally invasive technique for hemorrhoids
verfasst von
Hong-Cheng Lin
Qiu-Lan He
Dong-Lin Ren
Hui Peng
Shang-Kui Xie
Dan Su
Xiao-Xue Wang
Publikationsdatum
01.09.2012
Verlag
Springer Japan
Erschienen in
Surgery Today / Ausgabe 9/2012
Print ISSN: 0941-1291
Elektronische ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-011-0085-5

Weitere Artikel der Ausgabe 9/2012

Surgery Today 9/2012 Zur Ausgabe

Leitlinien kompakt für die Allgemeinmedizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Facharzt-Training Allgemeinmedizin

Die ideale Vorbereitung zur anstehenden Prüfung mit den ersten 49 von 100 klinischen Fallbeispielen verschiedener Themenfelder

Mehr erfahren

Bei Herzinsuffizienz muss „Eisenmangel“ neu definiert werden!

16.05.2024 Herzinsuffizienz Nachrichten

Bei chronischer Herzinsuffizienz macht es einem internationalen Expertenteam zufolge wenig Sinn, die Diagnose „Eisenmangel“ am Serumferritin festzumachen. Das Team schlägt vor, sich lieber an die Transferrinsättigung zu halten.

ADHS-Medikation erhöht das kardiovaskuläre Risiko

16.05.2024 Herzinsuffizienz Nachrichten

Erwachsene, die Medikamente gegen das Aufmerksamkeitsdefizit-Hyperaktivitätssyndrom einnehmen, laufen offenbar erhöhte Gefahr, an Herzschwäche zu erkranken oder einen Schlaganfall zu erleiden. Es scheint eine Dosis-Wirkungs-Beziehung zu bestehen.

Betalaktam-Allergie: praxisnahes Vorgehen beim Delabeling

16.05.2024 Pädiatrische Allergologie Nachrichten

Die große Mehrheit der vermeintlichen Penicillinallergien sind keine. Da das „Etikett“ Betalaktam-Allergie oft schon in der Kindheit erworben wird, kann ein frühzeitiges Delabeling lebenslange Vorteile bringen. Ein Team von Pädiaterinnen und Pädiatern aus Kanada stellt vor, wie sie dabei vorgehen.

Diabetestechnologie für alle?

15.05.2024 DDG-Jahrestagung 2024 Kongressbericht

Eine verbesserte Stoffwechseleinstellung und höhere Lebensqualität – Diabetestechnologien sollen den Alltag der Patienten erleichtern. Dass CGM, AID & Co. bei Typ-1-Diabetes helfen, ist belegt. Bei Typ-2 gestaltet sich die Sache komplizierter.

Update Allgemeinmedizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.