Treatment Of Prolapsed Hemorrhoids Research Articles

Tissue-selecting-technique mega-window stapler combined with anal canal epithelial preservation operation in prolapsed hemorrhoids

ObjectiveThis study aimed to compare the efficiency of these two combined surgeries [prolapse and hemorrhoids (PPH) combined with the external hemorrhoidectomy and inferior internal hemorrhoid ligation; tissue selecting technique with mega-window stapler (TST-MS) combined with anal canal epithelial preservation operation]. MethodsThis is a single-center, evaluator-blinded randomized controlled trial (RCT). A total of 204 participants were randomly divided into the two groups. The anal function, reoccurrence, intraoperative variables, and operative complications were assessed. The measurement data were compared by paired t test and rank sum test. Chi-squared or Fisher's exact test was used for count data and rank sum test for ranked data. To assess differences within each group in different time points, the repeated-measures analysis of variance was conducted. ResultsTST-MS combined with anal canal epithelial preservation operation had lower Wexner score of anal incontinence (Z = 3.062, P = 0.002), higher patients’ satisfaction degree (t = 7.32, P < 0.001), less residual skin tags (χ2 = 18.141, P < 0.001), longer operative time (Z = −2.281, P = 0.023), and bigger volume of excised rectal mucosa (t = 2.35, P = 0.020). There was no significant difference between the two groups in the anal canal circumference, recurrence, intraoperative blood loss, weight of excised rectal mucosa, anal pain, bleeding, urinary retention, anal edge edema, and anatomical anal stenosis (all P > 0.05). ConclusionsTST-MS combined with anal canal epithelial preservation operation showed better clinical efficiency in the treatment of prolapsed hemorrhoids. Trial registrationThis study has been registered in Chinese Clinical Trial Registry (ChiCTR2000038533)

Evaluation of clinical efficacy of suture-fixation mucopexy in the treatment of prolapsed hemorrhoid.

The aim of this study was to evaluate the clinical efficacy of suture-fixation mucopexy in the treatment of prolapsed hemorrhoids. A total of 123 patients with grade II, III, and IV hemorrhoids were admitted to The TCM Hospital of Pu Dong New District between 2018 and 2019. They were randomly divided into the suture-fixation group (SF, N.=60) and the Milligan-Morgan hemorrhoidectomy group (MM, N.=63). Clinical efficacy, postoperative pain, average operation time, hospital stay, complications, and patient satisfaction were prospectively evaluated. No significant differences were identified in clinical efficacy; operation time and hospital stay between the two groups (P>0.05). However, VAS Score in the SF group was lower than that in the MM group. And the SF group was also more advantageous in anal function protection (P<0.05). In addition, the results of the follow-up survey revealed no significant difference in postoperative recurrence rate and patient satisfaction (P>0.05). Compared with Milligan-Morgan hemorrhoidectomy, suture-fixation mucopexy is as effective in the treatment of prolapsed hemorrhoid, but it has more advantages in reducing postoperative pain and protecting the anal function.

Evaluation of clinical efficacy of suture-fixation mucopexy in the treatment of prolapsed hemorrhoid

Bachground To evaluate the clinical efficacy of suture-fixation mucopexy in the treatment of prolapsed hemorrhoids. Methods A total of 123 patients with grade II, III, and IV hemorrhoids were admitted to The TCM Hospital of Pu Dong New District between 2018 and 2019. They were randomly divided into the suture-fixation group (SF, n=60) and the Milligan-Morgan hemorrhoidectomy group (MM, n=63). Clinical efficacy, postoperative pain, average operation time, hospital stay, complications, and patient satisfaction were prospectively evaluated. Results No significant differences were identified in clinical efficacy, operation time and hospital stay between the two groups (P>0.05). However, VAS score in the SF group was lower than that in the MM group. And the SF group was also more advantageous in anal function protection (P 0.05). Conclusions Compared with Milligan-Morgan hemorrhoidectomy, suture-fixation mucopexy is as effective in the treatment of prolapsed hemorrhoid, but it has more advantages in reducing postoperative pain and protecting the anal function.

Consensus of Chinese experts on treatment of prolapsed hemorrhoids with transanal stapler

Prolapsed hemorrhoids is a common clinical disease, and severe symptoms can significantly affect work and life. The transanal stapler has the advantages of simple operation and less trauma in treating prolapsed hemorrhoids. Its clinical efficacy is closely related to the selection of indications, the standardization of surgical operations, and the prevention and treatment of complications. In current clinical practice, there is no consensus on the treatment of prolapsed hemorrhoids with transanal stapler. Hence a discussion was held by the Professional Committee of Colorectal Diseases of Chinese Society of Integrated Chinese and Western Medicine, concerning the indications, contraindications, operating specifications and perioperative management of prolapsed hemorrhoids. A consensus was consequently formed, aiming to provide a guideline for the clinical practice.