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Long-term Results After Stapled Hemorrhoidopexy: A Prospective Study With a 6-Year Follow-up.
MedLine Citation:
PMID:  21471762     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: : Stapled hemorrhoidopexy was introduced in 1998 as a new technique for treating advanced hemorrhoidal disease. Despite a clear perioperative advantage regarding pain and patient comfort, literature reviews indicate a higher recurrence rate for stapled hemorrhoidopexy than for conventional techniques.
OBJECTIVE: : Our aim was to present long-term on the use of this technique.
DESIGN: : Observational study.
SETTING AND PATIENTS: : Consecutive patients with hemorrhoid prolapse treated at a regional surgical center from May 27, 1999, through December 31, 2003.
INTERVENTION: : Stapled hemorrhoidopexy with accompanying resection of residual hemorrhoidal nodules if necessary.
MAIN OUTCOME MEASURES: : Standardized patient questionnaire regarding satisfaction, resolution of symptoms, and performance of further interventions.
RESULTS: : Of 257 patients (82 female, 175 male, mean age 53 ± 13 years) undergoing stapled hemorrhoidopexy, follow-up data were available for 224 patients (87.2%) with a mean duration of 6.3 ± 1.2 years. Of these, 195 patients (87.1%) were satisfied or very satisfied with the operation outcome; 19 patients (8.5%) were moderately satisfied; and 10 (4.5%) were not satisfied. Regarding preoperative anal symptoms, complete relief was observed in 179 patients (80.6%) for prolapse, 172 (77.5%) for bleeding, 139 (85.3%) for mucus discharge, 139 (78.5%) for burning sensation, and 115 (75.5%) for itching. Considering all recorded symptoms, 194 patients (86.6%) reported absence and or an improvement at follow-up. Twelve patients (5.4%) reported newly developed incontinence in the sense of urge symptoms; 42 patients out of 51 patients (82.4%) with preexisting incontinence reported an improvement. Local or topical retreatment (ointment, suppositories, sclerotherapy) was performed in 48 patients (21.4%). Reoperation for residual or newly developed hemorrhoidal nodules was needed in 8 patients (3.6%).
LIMITATIONS: : Lack of a comparative group.
CONCLUSION: : Our long-term results show that this strategy for stapled hemorrhoidopexy can achieve a high level of patient satisfaction and symptom control, with a low rate of reoperation for recurrent hemorrhoidal symptoms.
Authors:
A Ommer; Jakob Hinrichs; Horst Möllenberg; Babji Marla; Martin Karl Walz
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Diseases of the colon and rectum     Volume:  54     ISSN:  1530-0358     ISO Abbreviation:  Dis. Colon Rectum     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-04-07     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372764     Medline TA:  Dis Colon Rectum     Country:  United States    
Other Details:
Languages:  eng     Pagination:  601-8     Citation Subset:  IM    
Affiliation:
1Department for Surgery and Center for Minimally Invasive Surgery, Kliniken Essen-Mitte, Evang. Huyssens-Stiftung, Essen, Germany 2Center for Proctology, Essen-Rüttenscheid, Essen, Germany.
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