Details
Category: Volume 07 Issue 05 May 2019
Hits: 1323

Title: A Prospective comparative clinical study on the efficacy of stapler haemorrhoidopexy versus conventional haemorrhoidectomy in the management of haemorrhoids

Authors: Dr K.Vani, Dr Chiguruvada Muni Ajitha, Dr Konkena Janardhana Rao, Dr Yiza Ravindra Reddy, Dr Ravi Theja Bathalapalli, Dr K.Meghana

 DOI: https://dx.doi.org/10.18535/jmscr/v7i5.29

Abstract

Haemorrhoidal disease has been loathsome affliction of mankind. It is a painful condition to the sufferer and the treating surgeon. Several methods are available for the treatment of haemorrhoids ranging from the gold standard Milligan Morgan heamorrhoidectomy to the novel method of Stapler haemorrhoidopexy. With this background, a prospective comparative clinical study on the efficacy of stapler haemorrhoidopexy versus conventional haemorrhoidectomy in the management of haemorrhoids was conducted on 84 patients admitted in the Department of Surgery in a tertiary care hospital in the Rayalaseema districts of Andhra Pradesh from August, 2017 to March, 2019.

Conclusion: According to the results of our study, we consider Stapler hemorrhoidopexy as the preferred technique for the management of haemorrhoids given the appropriate conditions because of less post operative pain and morbidity than conventional techniques. However, because of the excessive cost of the stapler device, conventional hemorrhoidectomy remains the gold standard for the management of haemorrhoids  in developing  countries.

Keywords: Stapler, Hemorrhoidopexy, Conventional hemorrhoidectomy, Complications.

References

  1. Lan P, Wu X, Zhou X, Wang J, Zhang L. The safety and efficacy of stapled hemorrhoidectomy in the treatment of hemorrhoids: a systematic review and meta-analysis of ten randomized control trials. International journal of colorectal disease. 2006 Mar 1;21(2):172-8.
  2. Ferguson JA, Heaton JR. Closed hemorrhoidectomy. Diseases of the Colon & Rectum. 1959 Mar 1;2[2]:176-9
  3. Longo A. Treatment of Hemorrhoids Disease by Reduction of Mucosa and Hemorrhoidal Prolapse with a Circular stapler Suturing Device: A New Procedure. In Proceeding of the  6th World Congress of Endoscopic Surgery 1998 [pp. 777-784.]
  4. Ho YH, Cheong WK, Tsang C, Ho J, Eu KW, Tang CL, et al. Stapled Hemorrhoidectomy- cost and effectiveness. Randomized, controlled trial including incontinence Scoring, anorectal manometry, and endoanal ultrasound assessments at up to Three Months. Diseases of the colon & rectum. 2000 Dec 31;43[12]:1666-75.
  5. Smyth EF, Baker RP, Wilken BJ, Hartley JE, White TJ, Monson JR. Stapled versus excision haemorrhoidectomy: long-term follow up of a randomised controlled trial. The Lancet. 2003 Apr 26;361(9367):1437
  6. Shao WJ, Li GC, Zhang ZH, Yang BL, Sun GD,Chen YQ. Systematic review and meta analysis of randomized controlled trials comparing stapledhaemorrhoidopexy with conventional haemorrhoidectomy. Br J Surg. 2008;95(2):147-60.
  7. Tjandra JJ, Chan MK. Systematic review on the procedure for prolapse and haemorrhoids (stapledhaemorrhoi-dopexy). Dis Colon Rectum.2007; 50(6):878-92.
  8. Shukla S et al. Comparison between conventional haemorrhoidectomy and stapler haemorrhoidopexy Int Surg J. 2016 May;3(2):614-620.
  9. Aggarwal N et al.Stapled haemorrhoi-dopexy vs. penhaemorrhoidectomy: a comparative study Int Surg J. 2019 Apr;6(4):1259-1263.
  10. Rakhonde A et al. Haemorrhoidectomy - stapler versus conventional (open): our experience Int Surg J. 2016 May;3(2):729-735.
  11. Chen JS, You JF. Current status of surgical treatment for haemorrhoid systematic review andmeta-analysis. Chang Gung Med J. 2010;33(5):488-500.
  12. Gravie JF, Lehur PA, Huten N, Papillon M, FantoliM, Descottes B, et al. Stapled Haemorrhoidopexy Versus Milligan Morgan Haemorrhoidectomy; AnnSurg. 2005;242(1):29-35.
  13. Singh SP et al. Comparison between stapler hemorrhoidectomy and open hemorrhoidectomy in the management of grade III and IV hemorrhoids: Int Surg J. 2018 Jun;5(6):2069-2073.
  14. Sachin ID, Muruganathan OP. Stapled hemorrhoidopexy versus open hemorrhoidectomy: a comparative study of short term results. Int Surg J. 2017;4:472-816.
  15. Ortiz H, Marzo J, Armenderiz P. Randomized Clinical tral of stapled haemorrhoidopexy versus conventional diatermy haemorrhoidectomy. Br J Surg. 2002;89:1376-81.
  16. Baliga K et al. Stapler hemorrhoidectomy versus open hemorrhoidectomy, Int Surg J. 2016 Nov;3(4):1901-1905 .
  17. Molloy RG, Kingsmore D. Life-threatening pelvic sepsis after stapled hemorrhoidectomy. Lancet. 2000;355:810.
  18. Pescatori M. Transanal stapled excision of rectal mucosal prolapse. Tech Coloproctol. 1997;1:96-8.
  19. Cipriani S, Pescatori M. Acute rectal obstruction following PPH hemorrho-idectomy. Colorectal Disease. 2002;4:367-70.

Corresponding Author

Dr Konkena Janardhana Rao

Associate Professor of Surgery, Government Medical College (RIMS), Kadapa, India