DOI: http://dx.doi.org/10.18203/2349-2902.isj20200505

Our initial experience of three versus two rows circular stapler devices for stapled hemorrhoidopexy: a single institution review of 224 cases

Paritosh Gupta, Dhruv N. Kundra, Amanpriya Khanna, Akanksha Aggarwal, Kanu Kapoor

Abstract


Background: Stapled haemorrhoidopexy is a non-excisional approach for haemorrhoids as opposed to conventional open Milligan-Morgan and Ferguson closed haemorrhoidectomy techniques. It repositions the prolapsed haemorrhoid tissue and also causes vascular interruption to the haemorrhoids. This causes faster recovery and lesser post-operative pain.

Methods: In authors institute, stapled haemorrhoidopexy was being carried out using two rows proximate PPH circular haemorrhoidal stapler. In February 2018, MIRUS three rows circular stapler was introduced. This is a retrospective observational study carried out at Artemis Hospital, Gurgaon, India. Authors studied records and operative notes of all patients who underwent stapled haemorrhoidopexy between February 2018 and September 2019 and compared key parameters.

Results: A total of 224 patients underwent stapled haemorrhoidopexy between February 2018 and September 2019. 116 using MIRUS three rows circular stapler and 108 using two rows proximate PPH circular haemorrhoidal stapler. Most of the studied parameters were comparable with only significant statistical difference seen in higher use of haemostatic sutures in two rows stapler group compared to three rows stapler group. Haemostatic sutures were needed in three row stapler group for 27 patients and in two rows stapler group for 39 patients.

Conclusions: Author’s initial experience shows slightly better haemostasis with three rows stapled haemorrhoidopexy with no significant difference in other parameters.


Keywords


Haemorrhoid, Haemostasis, Stapled haemorrhoidopexy

Full Text:

PDF

References


Sayfan J, Becker A, Koltun L. Sutureless closed hemorrhoidectomy: a new technique. Ann Surg. 2001;234(1):21-4.

Gerbershagen HJ, Aduckathil S, Van Wijck AJ, Peelen LM, Kalkman CJ, Meissner W. Pain intensity on the first day after surgery: a prospective cohort study comparing 179 surgical procedures. Anesthesiology. 2013;118:934-44.

Longo A. Treatment of hemorrhoidal disease by reduction of mucosa and hemorrhoidal prolapse with a circular suturing device; 6th World Congress of Endoscopic Surgery; Rome, Italy: Bologna: Monduzzi; 1998: 777-784.

Araujo SE, Horcel LA, Seid VE, Bertoncini AB, Klajner S. Long term results after Stapled Hemorrhoidopexy alone and complemented by excisional Hemorrhoidectomy: A Retrospective Cohort Study. Arq Bras Cir Dig. 2016;29(3):159-63.

Systematic review on the procedure for prolapse and hemorrhoids (stapled hemorrhoidopexy).Tjandra JJ, Chan MK. Dis Colon Rectum. 2007;50(6):878-92.

Pavlidis T, Papaziogas B, Souparis A, Patsas A, Koutelidakis I, Papaziogas T. Modern stapled Longo procedure vs. conventional Milligan-Morgan hemorrhoidectomy: a randomized controlled trial. Int J Colorectal Dis. 2002;17(1):50-3.

Watson AJ, Bruhn H, MacLeod K, McDonald A, McPherson G, Kilonzo M, et al. A pragmatic, multicentre, randomised controlled trial comparing stapled haemorrhoidopexy to traditional excisional surgery for haemorrhoidal disease (eTHoS): study protocol for a randomised controlled trial. Trials. 2014;15(1):439.

Johanson JF, Sonnenberg A. The prevalence of hemorrhoids and chronic constipation. An epidemiologic study. Gastroenterol. 1990;98(2):380-6.

Rogozina VA. Eksp Klin Gastroenterol Exp Clin Gastroenterol. 2002;4:93-6.

Cohen Z. Symposium on outpatient anorectal procedures. Alternatives to surgical hemorrhoidectomy. Can J Surg J Can Chir. 1985;28(3):230-1.

Bartolo DC. Surgery of the anus, rectum and colon. Vols 1 and 2. MRB Keighley and NS Williams. 282× 205 mm. Pp. 2448. Illustrated. 1993. London: WB Saunders.£ 280. British J Surg. 1994;81(7):1085.

Corman ML, Gravié J-F, Hager T, Loudon MA, Mascagni D, Nyström P-O, et al. Stapled haemorrhoidopexy: a consensus position paper by an international working party - indications, contra-indications and technique. Colorectal Dis Off J Assoc Coloproctol G B Irel. 2003;5(4):304-10.

Lomanto D, Katara AN. Stapled Haemorrhoidopexy for Prolapsed Haemorrhoids: Short- and Long-term Experience. Asian J Surg. 2007;30(1):29-33.

Sutherland LM, Burchard AK, Matsuda K, Sweeney JL, Bokey EL, Childs PA, et al. A systematic review of stapled hemorrhoidectomy. - PubMed – NCBI. Available at: https://www.ncbi.nlm.nih.gov/ pubmed/12470107?dopt=Abstract. Accessed 11 December 2019.

Touzin E, Hegge S, McKinley C. Early experience of stapled hemorrhoidectomy in a community hospital setting. Can J Surg. 2006;49(5):316-20.

Foo CC, Chiu AH, Yip J, Law WL. Does advancement in stapling technology with triple-row and enhanced staple configurations confer additional safety? A matched comparison of 340 stapled ileocolic anastomoses. Surgical endoscopy. 2018;32(7):3122-30.