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Randomized Controlled Trial to Compare Stapled Hemorroidopexy Plus Ligation Anopexy With Stapled Hemorroidepexy for Managing Grade III and IV Hemorroidal Disease.
Diseases of the Colon and Rectum 2024 Februrary 22
BACKGROUND: Despite the benefits of the Stapled hemorrhoidopexy in the short term, management of prolapsing hemorrhoids, the long-term results are still insufficient, regarding recurrent prolapse and patient satisfaction so in our current study we add ligation anopexy to stapled hemorroidopexy.
OBJECTIVE: Valuation of adding ligation anopexy to stapled hemorroidopexy in improving short and long-term results in the treatment of grade III-IV hemorrhoids.
DATA SOURCES: Between January 2018 and January 2020 we recruited 124 patients with grade III-IV hemorrhoids, at Alexandria main university hospital.
STUDY SELECTION: Randomized controlled trial.
INTERVENTIONS: One hundred twenty-four patients were blindly randomized into two equal groups, stapled hemorrhoidopexy (group I) and stapled hemorrhoidopexy plus ligation anopexy (group II).
MAIN OUTCOME MEASURES: Recurrence of hemorrhoids and patient satisfaction after a follow-up period of at least two years.
RESULTS: The average operating time was noticeably less in stapled hemorroidopexy group. Meanwhile, postoperative pain, analgesia requirement, hemorrhoids symptoms score, return to work, complications rate, and quality of life 1 month after surgery were similar. Following a mean follow-up of 36 months (interval, 24-47), group I, 10 patients (16%) complained of recurrent external swelling and/or prolapse compared to 3 patients (5%) in group II (p = 0.0368) requiring redo surgery. No redo-surgery was required in group II, furthermore, long-term patient satisfaction was significantly better in group II.
LIMITATIONS: Longer follow-up needed and single-center experience.
CONCLUSIONS: Stapled hemorroidopexy compared to stapled hemorroidopexy plus ligation anopexy were similar at short-term results as regard complications rate, hemorrhoids symptoms score, return to work, and quality of life. Long-term results were significantly better as regard recurrence of external swelling and/or prolapse and patient satisfaction after stapled hemorroidopexy plus ligation anopexy. See Video Abstract.
TRIAL REGISTRATION NUMBER: Pan African Clinical Trials Registry identifier PACTR20180100293130.
OBJECTIVE: Valuation of adding ligation anopexy to stapled hemorroidopexy in improving short and long-term results in the treatment of grade III-IV hemorrhoids.
DATA SOURCES: Between January 2018 and January 2020 we recruited 124 patients with grade III-IV hemorrhoids, at Alexandria main university hospital.
STUDY SELECTION: Randomized controlled trial.
INTERVENTIONS: One hundred twenty-four patients were blindly randomized into two equal groups, stapled hemorrhoidopexy (group I) and stapled hemorrhoidopexy plus ligation anopexy (group II).
MAIN OUTCOME MEASURES: Recurrence of hemorrhoids and patient satisfaction after a follow-up period of at least two years.
RESULTS: The average operating time was noticeably less in stapled hemorroidopexy group. Meanwhile, postoperative pain, analgesia requirement, hemorrhoids symptoms score, return to work, complications rate, and quality of life 1 month after surgery were similar. Following a mean follow-up of 36 months (interval, 24-47), group I, 10 patients (16%) complained of recurrent external swelling and/or prolapse compared to 3 patients (5%) in group II (p = 0.0368) requiring redo surgery. No redo-surgery was required in group II, furthermore, long-term patient satisfaction was significantly better in group II.
LIMITATIONS: Longer follow-up needed and single-center experience.
CONCLUSIONS: Stapled hemorroidopexy compared to stapled hemorroidopexy plus ligation anopexy were similar at short-term results as regard complications rate, hemorrhoids symptoms score, return to work, and quality of life. Long-term results were significantly better as regard recurrence of external swelling and/or prolapse and patient satisfaction after stapled hemorroidopexy plus ligation anopexy. See Video Abstract.
TRIAL REGISTRATION NUMBER: Pan African Clinical Trials Registry identifier PACTR20180100293130.
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