Objective comparison of stapled anopexy and open hemorrhoidectomy: a randomized, controlled trial.

2.50
Hdl Handle:
http://hdl.handle.net/10541/80259
Title:
Objective comparison of stapled anopexy and open hemorrhoidectomy: a randomized, controlled trial.
Authors:
Wilson, Malcolm S; Pope, V; Doran, H E; Fearn, S J; Brough, W A
Abstract:
PURPOSE: 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. METHODS: 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. RESULTS: 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). CONCLUSIONS: 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.
Affiliation:
Department of Surgery, Christie Hospital, Wilmslow Road, Withington, Manchester M20 4BX, United Kingdom.
Citation:
Objective comparison of stapled anopexy and open hemorrhoidectomy: a randomized, controlled trial. 2002, 45 (11):1437-44 Dis. Colon Rectum
Journal:
Diseases of the Colon and Rectum
Issue Date:
Nov-2002
URI:
http://hdl.handle.net/10541/80259
DOI:
10.1097/01.DCR.0000034513.32571.51
PubMed ID:
12432288
Type:
Article
Language:
en
ISSN:
0012-3706
Appears in Collections:
All Christie Publications

Full metadata record

DC FieldValue Language
dc.contributor.authorWilson, Malcolm S-
dc.contributor.authorPope, V-
dc.contributor.authorDoran, H E-
dc.contributor.authorFearn, S J-
dc.contributor.authorBrough, W A-
dc.date.accessioned2009-09-08T11:36:31Z-
dc.date.available2009-09-08T11:36:31Z-
dc.date.issued2002-11-
dc.identifier.citationObjective comparison of stapled anopexy and open hemorrhoidectomy: a randomized, controlled trial. 2002, 45 (11):1437-44 Dis. Colon Rectumen
dc.identifier.issn0012-3706-
dc.identifier.pmid12432288-
dc.identifier.doi10.1097/01.DCR.0000034513.32571.51-
dc.identifier.urihttp://hdl.handle.net/10541/80259-
dc.description.abstractPURPOSE: 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. METHODS: 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. RESULTS: 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). CONCLUSIONS: 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.en
dc.language.isoenen
dc.subjectHaemorrhoidsen
dc.subject.meshAdult-
dc.subject.meshAged-
dc.subject.meshDigestive System Surgical Procedures-
dc.subject.meshDirect Service Costs-
dc.subject.meshHemorrhoids-
dc.subject.meshHumans-
dc.subject.meshLength of Stay-
dc.subject.meshManometry-
dc.subject.meshMiddle Aged-
dc.subject.meshPilot Projects-
dc.subject.meshPostoperative Complications-
dc.subject.meshQuality of Life-
dc.subject.meshSurgical Stapling-
dc.subject.meshSuture Techniques-
dc.titleObjective comparison of stapled anopexy and open hemorrhoidectomy: a randomized, controlled trial.en
dc.typeArticleen
dc.contributor.departmentDepartment of Surgery, Christie Hospital, Wilmslow Road, Withington, Manchester M20 4BX, United Kingdom.en
dc.identifier.journalDiseases of the Colon and Rectumen

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