Closed hemorrhoidectomy with linear stapler: a consecutive series of 300 patients.
In vivo (Athens, Greece)(2011)
摘要
Hemorrhoidectomy is one of the most commonly performed anorectal operations. The aim of this study was to evaluate the safety and the efficacy of a new technique for sutured closed hemorroidectomy with linear stapler in a consecutive series of 300 patients.Between January 2006 and December 2009, 300 patients (117 male, 183 female) (mean age, 52 (range 21-85) years) with grade III and IV hemorrhoids were treated with our modified technique with linear stapler with 6 cm vascular recharge. This technique essentially achieves a sutured closed hemorroidectomy. The primary end-points of the study were blood loss, time to achieve complete wound healing and recurrence; the secondary end-points were postoperative pain, operative time, hospital stay, patient satisfaction, need of analgesics and morbidity.Post-operative bleeding occurred in 8 patients (2.7%), requiring surgical hemostasis in 2 patients (0.6%). Overall, 132 patients (44%) reported no presence of pain, 43% defined it as light, the remaining 13% reported it as moderate and required the use of painkillers for about 1 month. Eight patients (2.7%) required postoperative temporary bladder catheterization because of acute urinary retention. The mean operative time was 13 minutes and the hospital stay was one day in 282 patients (94%), two days in 12 patients (4%) and three or more days in the remaining patients. None of the patients developed anal stenosis or fecal incontinence; 1 patient reported gas incontinence. The median follow-up was 23.4 months. All patients had complete wound healing within 6 months. Two patients had recurrent disease and were re-operated on with the same technique.Our modified sutured closed hemorrhoidectomy with linear stapler is a simple and safe technique and may be successfully applied for radical treatment in patients with third-degree or fourth-degree hemorrhoids.
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