Stapled hemorrhoidopexy: Clinical results of 65 cases

Pergel, Ahmet; ŞAHİN, Dursun Ali; AYDIN, Ibrahim; Yücel, Ahmet Fikret

Stapled hemorrhoidopexy: Clinical results of 65 cases

Ahmet PERGEL, (Recep Tayyip Erdoğan Üniversitesi, Tıp Fakültesi, Cerrahi Anabilim Dalı, Rize, Türkiye)

Ahmet Fikret YÜCEL, (Recep Tayyip Erdoğan Üniversitesi, Tıp Fakültesi, Cerrahi Anabilim Dalı, Rize, Türkiye)

İbrahim AYDIN, (Recep Tayyip Erdoğan Üniversitesi, Tıp Fakültesi, Cerrahi Anabilim Dalı, Rize, Türkiye)

Dursun Ali ŞAHİN (Recep Tayyip Erdoğan Üniversitesi, Tıp Fakültesi, Cerrahi Anabilim Dalı, Rize, Türkiye)

Journal of Clinical and Experimental Investigations

2 0

Yıl: 2012 Cilt: 3 Sayı: 3 Sayfa Aralığı: 340 - 344 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Stapled hemorrhoidopexy: Clinical results of 65 cases

Öz:

Amaç: Hemoroidal hastalık sebebiyle stapler hemoroidopeksi uyguladığımız hastalarımızın sonuçlarını sunmak ve literatür eşliğinde tartışmak. Gereç ve yöntem: Ocak 2009- Nisan 2011 tarihleri arasında 3-4. derece hemoroidal hastalık tanısı konan ve Longo yöntemiyle hemoroidopeksi uygulanan hastalar çalışmaya dahil edildi. Tüm veriler prospektif toplanıp retrospektif olarak incelendi. Hastalar; demografik özellikler, başvuru sırasındaki şikayetler, ameliyat sonrası komplikasyonlar açısından değerlendirildi. Bulgular: Toplam 65 hastadan 43 (% 66)ü erkek, 22 (% 34)si kadındı. Ortalama yaş 38±11.9 (23-76) yıl idi. Olguların en sık başvuru şikayetleri sıklık sırasına göre kanama, şişlik, kaşıntı, ağrı, kabızlık şeklinde idi. Elli sekiz (% 89) hastada 3. derece, 7 (%11) hastada 4. derece hemoroid mevcuttu. Ortalama ameliyat süresi 37.6±8.1(24-55) dakika, ortalama yatış süresi 27±7.8 (20-76) saat idi. Toplam 17 (% 26) hastada bir ya da daha fazla komplikasyon gelişti. Komplikasyon olarak 13 (% 20) hastada kanama, 6 (%9)sında ağrı, 2 (% 3)sinde idrar retansiyonu, 3 (% 5)ünde tenezm, 1 (% 2) inde eksternal hemoroidal tromboz, 4 (%6)ünde ise nüks saptandı. Sonuç: Stapler hemoroidopekside ağrının az ve iyileşme sürecinin hızlı olması nedeniyle hastalar günlük aktivitelerine erken dönebilmektedirler. Bu yöntemin başarısında uygun hasta seçimi ve tekniğin doğru uygulanmasının önemli olduğunu düşünmekteyiz. Özellikle 3.derece hemoroidal hastalıkta Longo tekniği klasik yöntemlere alternatif olarak önerilebilir.

Anahtar Kelime:

Konular: Cerrahi

Stapler hemoroidopeksi: 65 olguda klinik sonuçlar

Öz:

Objectives: To present results of our patients underwent stapled hemorrhoidopexy due to hemorrhoidal disease and discuss in accompaniment with the literature. Material and methods: The patients, who diagnosed by 3rd-4th degree hemorrhoidal disease and underwent hemorrhoidopexy with Longo method between January, 2009 and April, 2011, were included. All data were prospectively collected and retrospectively examined. The patients were evaluated in terms of demographic properties, complaints on admission, and postoperative complications. Results: Forty-three (66%) of 65 patients were male, 22 (34%) were female. The mean age was 38±11.9 (range:23-76) years. The most frequent complaints were bleeding, swelling, itching, pain, constipation respectively. Third degree hemorrhoid was present in fifty-eight (89%) patients, 4th degree hemorrhoid was in 7 (11%) patients. The mean operation duration was 37.6±8.1(range:24-55) minutes, the mean hospitalization duration was 27±7.8 (range:20-76) hours. One or more complication developed in total 17 (26%) patients. As complication, bleeding was determined in 13 (20%) patients, pain was in 6 (9%), urinary retention was in 2 (3%), tenesmus was in 3 (5%), external hemorrhoidal thrombosis was in 1 (2%), and recurrence was in 4 (6%). Conclusions: The patients can return their daily activities early with stapled hemorrhoidopexy because of less pain and quick recovery period. We consider that appropriate patient selection and proper application of the technique are important in the success of this method. Particularly in 3rd degree hemorrhoidal disease, Longo s technique can be suggested as an alternative to classical methods.

Anahtar Kelime:

Konular: Cerrahi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Demirbaş S, Aktaş O, Öğün İ, Yağcı G. Haemorrhoidectomy by using circular stapler in grade III-IV Hemorrhoids. T Klin J Med Sci 2002;22(1):36-41.
2. Ganio E, Altomare DF, Gabrielli F, Milito G, Canuti S. Prospective randomized multicentre trial comparing stapled with open hemorrhoidectomy. Br J Surg 2001;88(5):669-74.
3. Boccasanta P, Capretti PG, Venturi M, et al. Randomised controlled trial between stapled circumferential mucosectomy and conventional circular hemorrhoidectomy in advanced hemorrhoids with external mucosal prolapse. Am J Surg 2001;182(1):64-8.
4. Rowsell M, Bello M, Hemingway DM. Circumferential mucosectomy (stapled haemorrhoidectomy) versus conventional haemorrhoidectomy: randomised controlled trial. Lancet 2000;355(9206):779-81.
5. Gravié JF, Lehur PA, Huten N, et al. Stapled hemorrhoidopexy versus milligan-morgan hemorrhoidectomy: a prospective, randomized, multicenter trial with 2-year postoperative follow up. Ann Surg 2005;242(1):29-35.
6. Sutherland LM, Burchard AK, Matsuda K, et al. A systematic review of stapled hemorrhoidectomy. Arch Surg 2002;137(12):1395-406.
7. Maw A, Eu KW, Seow-Choen F. Retroperitoneal sepsis complicating stapled hemorrhoidectomy: report of a case and review of the literature. Dis Colon Rectum 2002;45(6):826-8.
8. Wong LY, Jiang JK, Chang SC, Lin JK. Rectal perforation: a life-threatening complication of stapled hemorrhoidectomy: report of a case. Dis Colon Rectum 2003;46(1):116-7.
9. Cheetham MJ, Mortensen NJM, Nystom PO, Kamm MA, Phillips RKS. Persistent pain and faecal urgency after stapled haemorrhoidectomy. Lancet 2000;356(9231):730-3.
10. Herold A, Kirsch JJ. Pain after stapled haemorrhoidectomy. Lancet 2000;356(9231):2187-90.
11. Fazio VW. Early promise of stapling technique for haemorrhoidectomy. Lancet. 2000;355(9206):768-9
12. Ravo B, Amato A, Bianco V, et al. Complications after stapled hemorrhoidectomy: can they be prevented? Tech Coloproctol 2002;6(2):83-8.
13. 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. Rome, Italy: Surgery; 1998.
14. Terzi C, Füzün M. Anorektumun Benign Hastalıkları. Sayek İ. Temel Cerrahi 3. Baskı. Ankara: Güneş Kitabevi, 2004:1256-68
15. Nisar PJ, Acheson AG, Neal KR, Scholefield JH. Stapled hemorrhoidopexy compared with conventional hemorrhoidectomy: systematic review of randomized, controlled trials. Dis Colon Rectum 2004;47(11):1837- 45.
16. Palimento D, Picchio M, Attanasio U, Lombardi A, Bambini C, Renda A. Stapled and open hemorrhoidectomy: randomized controlled trial of early results. World J Surg 2003;27(2):203-7.
17. Oughriss M, Yver R, Faucheron JL. Complications of stapled hemorrhoidectomy: a French multicentric study. Gastroenterol Clin Biol 2005;29(4):429-33.
18. Papillon M, Arnaud JP, Descottes B, Gravie JF, Huten X, De Manzini N. Treatment of hemorrhoids with the Longo technique. Preliminary results of a prospective study on 94 cases. Chirurgie 1999;124(6):666-9.
19. Orrom W, Hayashi A, Rusnak C, Kelly J. Initial experience with stapled anoplasty in the operative management of prolapsing hemorrhoids and mucosal rectal prolapse. Am J Surg 2002;18385):519-24.
20. Cheetham MJ, Cohen CR, Kamm MA, Phillips RK. A randomized, controlled trial of diathermy hemorrhoidectomy vs. stapled hemorrhoidectomy in an intended day-care setting with longer-term follow-up. Dis Colon Rectum 2003;46(4):491-7.
21. Habr-Gama A, e Sous AH Jr, Roveló JM, et al. Stapled hemorrhoidectomy: initial experience of a Latin American group. J Gastrointest Surg 2003;7(6):809-13.
22. Hetzer FH, Demartines N, Handschin AE, Clavien PA. Stapled vs excision hemorrhoidectomy: long-term results of a prospective randomized trial. Arch Surg 2002;137(3):337-40.
23. Khalil KH, OBichere A, Sellu D. Randomized clinical trial of sutured versus stapled closed hemorrhoidectomy. Br J Surg 2000;87(10):1352-5.
24. Mehigan BJ, Monson JR, Hartley JE. Stapling procedure for haemorrhoids versus Milligan-Morgan haemorrhoidectomy: randomized controlled trial. Lancet 2000;355(9206):782-5.
25. Nahas SC, Borba MR, Brochado MCT, Marques CFS, Nahas CSR, Miott-Neto B. Stapled hemorrhoidectomy for the treatment of hemorrhoids. Arq Gastroenterol 2003;40(1):35-9.
26. Shalaby R, Desoky A. Randomized clinical trial of stapled versus Milligan-Morgan hemorrhoidectomy. Br J Surg 2001;88(8):1049-53.
27. Corman ML, Gravié JF, Hager T, et al. Stapled haemorrhoidopexy: a consensus position paper by an international working party - indications, contra-indications and technique. Colorectal Dis 2003;5(4):304-10.
28. Ho YH, Tsang C, Tang CL, Nyam D, Eu KW, Seow- Choen F. Anal sphincter injuries from stapling instruments introduced transanally: randomized, controlled study with endoanal ultrasound and anorectal manometry. Dis Colon Rectum. 2000;43(2):169-73.
29. Ortiz H, Marzo J, Armendariz P. Randomized clinical trial of stapled hemorrhoidopexy versus conventional diathermy hemorrhoidectomy. Br J Surg 2002;89(11):1376-81.
30. Molloy RG, Kingsmore D. Life threatening pelvic sepsis after stapled haemorrhoidectomy. Lancet 2000;355(9206):810.
31. Smith EF, Baker RP, Wilken BJ, Hartley JE, White TJ, Monson JR. Stapled versus excision haemorrhoidectomy: long-term follow-up of a randomised controlled trial. Lancet 2003;361(9367):1437-8.
32. Mattana C, Coco C, Manno A, et al. Stapled hemorrhoidopexy and Milligan Morgan hemorrhoidectomy in the cure of fourth-degree hemorrhoids: long-term evaluation and clinical results. Dis Colon Rectum 2007;50(11):1770-5.
33. Jayaraman S, Colquhoun PH, Malthaner RA. Stapled hemorrhoidopexy is associated with a higher longterm recurrence rate of internal hemorrhoids compared with conventional excisional hemorrhoid surgery. Dis Colon Rectum 2007;50(9):1297-305.

APA	Pergel A, Yücel A, AYDIN I, ŞAHİN D (2012). Stapled hemorrhoidopexy: Clinical results of 65 cases. , 340 - 344.
Chicago	Pergel Ahmet,Yücel Ahmet Fikret,AYDIN Ibrahim,ŞAHİN Dursun Ali Stapled hemorrhoidopexy: Clinical results of 65 cases. (2012): 340 - 344.
MLA	Pergel Ahmet,Yücel Ahmet Fikret,AYDIN Ibrahim,ŞAHİN Dursun Ali Stapled hemorrhoidopexy: Clinical results of 65 cases. , 2012, ss.340 - 344.
AMA	Pergel A,Yücel A,AYDIN I,ŞAHİN D Stapled hemorrhoidopexy: Clinical results of 65 cases. . 2012; 340 - 344.
Vancouver	Pergel A,Yücel A,AYDIN I,ŞAHİN D Stapled hemorrhoidopexy: Clinical results of 65 cases. . 2012; 340 - 344.
IEEE	Pergel A,Yücel A,AYDIN I,ŞAHİN D "Stapled hemorrhoidopexy: Clinical results of 65 cases." , ss.340 - 344, 2012.
ISNAD	Pergel, Ahmet vd. "Stapled hemorrhoidopexy: Clinical results of 65 cases". (2012), 340-344.

APA	Pergel A, Yücel A, AYDIN I, ŞAHİN D (2012). Stapled hemorrhoidopexy: Clinical results of 65 cases. Journal of Clinical and Experimental Investigations, 3(3), 340 - 344.
Chicago	Pergel Ahmet,Yücel Ahmet Fikret,AYDIN Ibrahim,ŞAHİN Dursun Ali Stapled hemorrhoidopexy: Clinical results of 65 cases. Journal of Clinical and Experimental Investigations 3, no.3 (2012): 340 - 344.
MLA	Pergel Ahmet,Yücel Ahmet Fikret,AYDIN Ibrahim,ŞAHİN Dursun Ali Stapled hemorrhoidopexy: Clinical results of 65 cases. Journal of Clinical and Experimental Investigations, vol.3, no.3, 2012, ss.340 - 344.
AMA	Pergel A,Yücel A,AYDIN I,ŞAHİN D Stapled hemorrhoidopexy: Clinical results of 65 cases. Journal of Clinical and Experimental Investigations. 2012; 3(3): 340 - 344.
Vancouver	Pergel A,Yücel A,AYDIN I,ŞAHİN D Stapled hemorrhoidopexy: Clinical results of 65 cases. Journal of Clinical and Experimental Investigations. 2012; 3(3): 340 - 344.
IEEE	Pergel A,Yücel A,AYDIN I,ŞAHİN D "Stapled hemorrhoidopexy: Clinical results of 65 cases." Journal of Clinical and Experimental Investigations, 3, ss.340 - 344, 2012.
ISNAD	Pergel, Ahmet vd. "Stapled hemorrhoidopexy: Clinical results of 65 cases". Journal of Clinical and Experimental Investigations 3/3 (2012), 340-344.