Objective Comparison of Stapled Anopexy and Open Hemorrhoidectomy
- 1 November 2002
- journal article
- clinical trial
- Published by Ovid Technologies (Wolters Kluwer Health) in Diseases of the Colon & Rectum
- Vol. 45 (11), 1437-1444
- https://doi.org/10.1007/s10350-004-6446-z
Abstract
This trial compares stapled anopexy with open hemorrhoidectomy in patients with prolapsing (Grade 3) hemorrhoids. Particular attention was paid to changes in anorectal physiology, nature of tissue resected, quality-of-life assessments, and cost implications of the treatments studied. An initial pilot study was followed by a randomized, controlled trial in a District General Hospital in the United Kingdom. All patients had Grade 3 hemorrhoids. Nineteen patients were studied in the pilot study, with 99 patients in the randomized, controlled trial. All patients in the pilot study and 59 in the randomized, controlled trial underwent stapled anopexy. Thirty patients in the randomized, controlled trial underwent open hemorrhoidectomy. Of the 59 patients in the stapled group, 32 were treated with the Ethicon PPH stapling device, and 27 received stapling with a reusable Autosuture stapling device. The following variables were measured: demographic details, quality of life (Medical Outcomes Study Short Form 36 and directed questions), anorectal manometry, and histology. There was no difference in the case mix within or between the groups. The stapled anopexy groups showed a significant reduction in operative time (P < 0.001) and blood loss (P < 0.001) compared with open hemorrhoidectomy. Open hemorrhoidectomy resulted in significantly greater usage of protective pads postoperatively (P < 0.001) and longer rehabilitation (P < 0.006). Stapled anopexy is an effective alternative treatment for prolapsing hemorrhoids that allows reduced operative time and shorter rehabilitation. It does not appear to affect continence or overall quality of life.Keywords
This publication has 10 references indexed in Scilit:
- Persistent pain and faecal urgency after stapled haemorrhoidectomyThe Lancet, 2000
- A prospective evaluation of the introduction of circumferential stapled anoplasty in the management of haemorrhoids and mucosal prolapseColorectal Disease, 2000
- Stapled haemorrhoidectomyColorectal Disease, 2000
- Circumferential mucosectomy (stapled haemorrhoidectomy) versus conventional haemorrhoidectomy: randomised controlled trialThe Lancet, 2000
- Stapling procedure for haemorrhoids versus Milligan-Morgan haemorrhoidectomy: randomised controlled trialThe Lancet, 2000
- Early promise of stapling technique for haemorrhoidectomyThe Lancet, 2000
- Treatment of external anorectal mucosal prolapse with circular staplerDiseases of the Colon & Rectum, 1999
- Double-blind randomised controlled trial of effect of metronidazole on pain after day-case haemorrhoidectomyThe Lancet, 1998
- Randomized trial of internal anal sphincter plication with pelvic floor repair for neuropathic fecal incontinenceDiseases of the Colon & Rectum, 1995
- SURGICAL ANATOMY OF THE ANAL CANAL, AND THE OPERATIVE TREATMENT OF HÆMORRHOIDSThe Lancet, 1937