BACKGROUND: This randomized study compared the medium-term results of stapled anopexy (SA) and transanal hemorrhoidal dearterialization with anopexy (THD) in 4 homogeneous groups of patients, 2 with third- and 2 with fourth-degree hemorrhoids. METHODS: Forty patients with third-degree and 30 with fourth-degree hemorrhoids were randomly submitted to SA (N.=20+15) and THD (N.=20+15), respectively. Clinical controls were done every 6 months from 1 to 42 months after the operation, with incidence of recurrent hemorrhoids as primary outcome measure. Operative time, complications, pain, time to return to normal activity, costs, Short Form-36, and overall patient satisfaction were also evaluated. RESULTS: Frequencies of preoperative obstructed defecation symptoms and prolapse recurrence were higher in patients with fourth-degree hemorrhoids, and SA was more effective than THD in reducing the risk of recurrence at 36±6 months follow-up (P=0.049). Operative time, complications, pain, and time of return to normal activity were similar in the 4 groups. Costs were significantly higher for SA in patients with fourth-degree hemorrhoids (P>0.01). A significant improvement of quality of life was observed in all groups, and no significant difference was found in overall patient satisfaction. CONCLUSIONS: Both techniques are safe and effective in the mid-term period. SA is more effective in reducing prolapse and obstructed defecation symptoms in fourth-degree hemorrhoids, with the disadvantage of higher costs. Prolapse size and presence of obstructed defecation symptoms could be predictive criteria for choice of the best surgical technique (Cite this article as: Venturi M, Salamina G, Vergani C. Stapled anopexy versus transanal hemorrhoidal dearterialization for hemorrhoidal disease: a three-year follow-up from a randomized study. Minerva Chir 2016;71:365-71)

Stapled anopexy versus transanal haemorrhoidal dearterialization for haemorrhoidal disease: a three-year follow-up from a randomized study / M. Venturi, G. Salamina, C. Vergani. - In: MINERVA CHIRURGICA. - ISSN 0026-4733. - 71:6(2016 Dec), pp. 365-371.

Stapled anopexy versus transanal haemorrhoidal dearterialization for haemorrhoidal disease: a three-year follow-up from a randomized study

C. Vergani
Ultimo
2016

Abstract

BACKGROUND: This randomized study compared the medium-term results of stapled anopexy (SA) and transanal hemorrhoidal dearterialization with anopexy (THD) in 4 homogeneous groups of patients, 2 with third- and 2 with fourth-degree hemorrhoids. METHODS: Forty patients with third-degree and 30 with fourth-degree hemorrhoids were randomly submitted to SA (N.=20+15) and THD (N.=20+15), respectively. Clinical controls were done every 6 months from 1 to 42 months after the operation, with incidence of recurrent hemorrhoids as primary outcome measure. Operative time, complications, pain, time to return to normal activity, costs, Short Form-36, and overall patient satisfaction were also evaluated. RESULTS: Frequencies of preoperative obstructed defecation symptoms and prolapse recurrence were higher in patients with fourth-degree hemorrhoids, and SA was more effective than THD in reducing the risk of recurrence at 36±6 months follow-up (P=0.049). Operative time, complications, pain, and time of return to normal activity were similar in the 4 groups. Costs were significantly higher for SA in patients with fourth-degree hemorrhoids (P>0.01). A significant improvement of quality of life was observed in all groups, and no significant difference was found in overall patient satisfaction. CONCLUSIONS: Both techniques are safe and effective in the mid-term period. SA is more effective in reducing prolapse and obstructed defecation symptoms in fourth-degree hemorrhoids, with the disadvantage of higher costs. Prolapse size and presence of obstructed defecation symptoms could be predictive criteria for choice of the best surgical technique (Cite this article as: Venturi M, Salamina G, Vergani C. Stapled anopexy versus transanal hemorrhoidal dearterialization for hemorrhoidal disease: a three-year follow-up from a randomized study. Minerva Chir 2016;71:365-71)
Hemorrhoids - Sutures - Rectal prolapse - Transanal endoscopic surgery.
Settore MED/18 - Chirurgia Generale
Settore MED/12 - Gastroenterologia
dic-2016
4-nov-2016
http://www.minervamedica.it/en/journals/minerva-chirurgica/article.php?cod=R06Y2016N06A0365
Article (author)
File in questo prodotto:
File Dimensione Formato  
SA VS THD[1].pdf

accesso riservato

Descrizione: Articolo principale + tabelle dati
Tipologia: Pre-print (manoscritto inviato all'editore)
Dimensione 257.76 kB
Formato Adobe PDF
257.76 kB Adobe PDF   Visualizza/Apri   Richiedi una copia
MINERVACHIRURGICAR06Y2016N06A0365.pdf

accesso riservato

Tipologia: Publisher's version/PDF
Dimensione 343.76 kB
Formato Adobe PDF
343.76 kB Adobe PDF   Visualizza/Apri   Richiedi una copia
Pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/460439
Citazioni
  • ???jsp.display-item.citation.pmc??? 1
  • Scopus 8
  • ???jsp.display-item.citation.isi??? 8
social impact