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- W2741153699 abstract "ABSTRACTObjective: Unlike excisional haemorrhoidectomy, stapledanopexy (SA), which does not involve radical excision, hastheoretical advantages, thus offering potential patientbenefits. We compared the clinical efficacy, safety andpatient acceptability of SA, with closed haemorrhoid-ectomy (CH).Patients and methods: 182 patients with symptomatichaemorrhoids (grades II, III, IV) were randomly assignedto receive SA or CH and were followed for up to 1 year(6, 12, 24, 48 weeks) after operation. Postoperative pain,symptom control, complications, re-treatment rates,patient satisfaction, and quality of life were compared onan intention-to-treat basis.Results: Postoperative pain in the SA group (n=91)was significantly lower (p=0.004, Mann–Whitney Utest). At 1 year there were no significant differences inthe symptom load, symptom severity or the diseaseseverity between the two groups. Overall complicationrates were similar but faecal urgency was reported morefrequently following SA (p=0.093, Fisher’s exact test).Despite a similar rate of residual symptoms, prolapsecontrol was better with CH (p=0.087, Fisher’s exacttest), and more patients in the SA group required re-treatment for residual prolapse at 1 year (p=0.037,Fisher’s exact test). However, more patients rated SA asan excellent operation at 6 and 12 weeks (p=0.008 and0.033, binary logistic regression) and were willing toundergo a repeat procedure if required (p=0.018,Fisher’s exact test).Conclusion: Stapled anopexy offers a significantly lesspainful alternative to excisional haemorrhoidectomy andachieves a higher patient acceptability. Although theoverall symptom control and safety are similar in themajority of the patients, the re-treatment rate forrecurrent prolapse at 1 year is higher following SA whencompared to CH.Excisional haemorrhoidectomy has long been the‘‘gold standard’’ treatment for haemorrhoidsdespite it being a painful operation with prolongedrehabilitation time," @default.
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- W2741153699 date "2009-01-01" @default.
- W2741153699 modified "2023-09-24" @default.
- W2741153699 title "closed diathermy haemorrhoidectomy acceptability of circular stapled anopexy with comparing the clinical efficacy, safety and patient Prospective randomised multi-centre trial" @default.
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