| Hemorrhoidectomy vs. Lord's method: 17-year follow-up of a prospective, randomized trial. | |
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MedLine Citation:
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PMID: 10789746 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: A prospective, randomized trial was performed between 1979 and 1981 comparing anal dilation and hemorrhoidectomy for hemorrhoidal disease at the Maastricht University Hospital. The aim of this study was to update that trial to assess long-term outcome and complications such as fecal incontinence. METHODS: A total of 138 patients with second-degree and third-degree hemorrhoids entered the study. Median follow-up was 17 (range, 8.4-18.3) years and was achieved for 118 (86 percent) patients. Group A (n = 35) underwent hemorrhoidectomy and Group B (n = 39) was treated with anal dilation and aftertreatment (original Lord's procedure), whereas Group C (n = 44) had dilation only. Fourteen of these patients died. RESULTS: Recurrent hemorrhoids were noted for 26 percent of the patients treated with hemorrhoidectomy, for 46 percent with operative dilation with the postoperative dilation program, and for 39 percent with operative dilation without the postoperative program. The percentage of repeated treatment for the three subgroups was 11, 23, and 18 percent, respectively. The continence status remained more or less the same during the first year. However, 17 years later the anal stretch procedures caused various incontinence disorders in 52 percent of these patients. Significance was found for incontinence of flatus (from 11 to 30 patients; P = 0.04) in the anal dilation groups. CONCLUSIONS: Hemorrhoidectomy can be considered to be a safe procedure for treatment of hemorrhoidal disease, with excellent long-term results. Anal dilation is associated with a high percentage of complaints of fecal incontinence. The procedure should be abandoned. |
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Authors:
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J Konsten; C G Baeten |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: Diseases of the colon and rectum Volume: 43 ISSN: 0012-3706 ISO Abbreviation: Dis. Colon Rectum Publication Date: 2000 Apr |
Date Detail:
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Created Date: 2000-05-09 Completed Date: 2000-05-09 Revised Date: 2005-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0372764 Medline TA: Dis Colon Rectum Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 503-6 Citation Subset: IM |
Affiliation:
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Department of Surgery, University Hospital Maastricht, The Netherlands. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Anal Canal / pathology*, surgery Dilatation / adverse effects Fecal Incontinence / etiology* Female Follow-Up Studies Hemorrhoids / pathology, surgery* Humans Male Middle Aged Postoperative Complications Prospective Studies Recurrence Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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