Modified stapled hemorrhoidopexy for lower postoperative stenosis: A five-year experience  

作　　者：Yu-Hong Liu Tzu-Chiao Lin Chao-Yang Chen Ta-Wei Pu 

机构地区：[1]Division of Colon and Rectal Surgery,Department of Surgery,Tri-Service General Hospital,National Defense Medical Center,Taipei 105,Taiwan,China [2]Division of Colon and Rectal Surgery,Department of Surgery,Tri-Service General Hospital Songshan Branch,National Defense Medical Center,Taipei 105,Taiwan,China

出　　处：《World Journal of Gastrointestinal Surgery》2024年第9期2787-2795,共9页世界胃肠外科杂志（英文版）（电子版）

摘　　要：BACKGROUND Stapled hemorrhoidopexy(SH)is currently a widely accepted method for treating the prolapse of internal hemorrhoids.Postoperative anal stenosis is a critical complication of SH.A remedy for this involves the removal of the circumferential staples of the anastomosis,followed by the creation of a hand-sewn anastomosis.Numerous studies have reported modified SH procedures to improve outcomes.We hypothesized that our modified SH technique may help reduce complications of anal stenosis after SH.AIM To compare outcomes of staple removal at the 3-and 9-o’clock positions during modified SH in patients with mixed hemorrhoids.METHODS This was a single-center,retrospective,observational study.Patients with grade III or IV hemorrhoids who underwent standard or modified SH at our colorectal center between January 1,2015,and January 1,2020,were included.The operation time,blood loss,length of hospital stay,and incidence of minor or major complic-ations were recorded.RESULTS Patients with grade III or IV hemorrhoids who underwent standard or modified SH at our colorectal center between January 1,2015 and January 1,2020,were included.Operation time,blood loss,length of hospital stay,and incidence of minor or major complications were recorded.We investigated 187 patients(mean age,50.9 years)who had undergone our modified SH and 313 patients(mean age,53.0 years)who had undergone standard SH.In the modified SH group,54%of patients had previously undergone surgical intervention for hemorrhoids,compared with the 40.3%of patients in the standard SH group.The modified SH group included five(2.7%)patients with anal stenosis,while 21(6.7%)patients in the standard SH group had complications of anal stenosis.There was a significant relationship between the rate of postoperative anal stenosis and the modified SH:0.251(0.085-0.741)and 0.211(0.069-0.641)in multiple regression analysis.The modified SH technique is a safe surgical method for advanced grade hemorrhoids and might result in a lower rate of postoperative anal stenosis t

关 键 词：Anal canal HEMORRHOIDS PROLAPSE Stapled hemorrhoidopexy Postoperative anal stenosis Modified stapled hemorrhoidopexy 

分 类 号：R657.5[医药卫生—外科学]