Less postoperative pain and more frequent recurrence: Can this dilemma caused by the Stapled Hemorrhoidopexy Procedure be avoided?

2021 ◽  
Author(s):  
Veysi Hakan Yardimci
Keyword(s):  
Postoperative Pain ◽  
Stapled Hemorrhoidopexy

scholarly journals Postoperative recovery; Stapled Hemorrhoidopexy versus Conventional haemorrhoidectomy.

2020 ◽  
Vol 27 (01) ◽  
pp. 166-171
Author(s):  
Ashar Ahmad Khan ◽  
Tania Mahar ◽  
Muhammad Kashif Adnan ◽  
Abdul Rasheed Surahio ◽  
Abdul Manan ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Hospital Stay ◽  
Postoperative Recovery ◽  
Stapled Hemorrhoidopexy ◽  
Anal Stenosis ◽  
P Value ◽  
Group A ◽  
Conventional Haemorrhoidectomy ◽  
Group B

Conventional haemorrhoidectomy, a usual procedure for hemorrhoids in our set up have many short and long term complications. Some patients complained pain many weeks after surgery and are unable to do their routine work. Anal stenosis and recurrence are long term issues. There is need for some other procedure which can decrease postoperative pain and hospital stay. Objectives: To compare the postoperative recovery between stapled hemorrhoidopexy and conventional hemorrhoidectomy. Study Design: Randomized Clinical trial. Setting: Surgery Department of Nishtar Medical University Multan. Period: from 01-01-2018 to 31-12-2018. Material & Methods: Randomly 02 equal groups of the patients, A and B were made. Stapled hemorrhoidopexy (SH) and conventional haemorrhoidectomy was done in group A and B respectively. SPSS version 20 used for data analysis. Mean and standard deviation were used for quantitative variables including postoperative pain, age and hospital stay. Independent Student t test used for comparison of hospital stay and postoperative pain. Effect modifier including gender, age, duration and grade of hemorrhoids were controlled by stratification and Chi square test was applied. P value less than 0.05 was taken as significant. Results: Out of 60 patients, 32 were males and 28 females. In Group A (Stapled Hemorrhoidopexy), mean age was 37.37 + 6.36 years and 39.17 + 5.53 years in Group-B. Postoperative pain in Group A was 3.60 + 1.27 and 6.03 + 1.73 in Group B. Postoperative pain was significantly high in Group B (CH) and P value =0.000. Mean hospital stay was 0.90 + 0.48 days in Group A and 1.87 + 0.57 days in Group B with P value= 0.000. Conclusion: Stapled hemorrhoidopexy is associated with shorter hospital stay and decrease postoperative pain irrespective of age, sex and grade of the hemorrhoids.

scholarly journals A comparative study of short term results of open haemorrhoidectomy and stapler haemorrhoidopexy

2017 ◽  
Vol 4 (10) ◽  
pp. 3358
Author(s):  
Chandrasekhar S. Neeralagi ◽  
Yogesh Kumar ◽  
Surag K. R. ◽  
Lakkanna Suggaiah ◽  
Preetham Raj
Keyword(s):  
Surgical Treatment ◽  
Postoperative Pain ◽  
Return To Work ◽  
Hospital Stay ◽  
Stapled Hemorrhoidopexy ◽  
Short Term ◽  
Post Operative Pain ◽  
Duration Of Surgery ◽  
Operative Complications ◽  
Post Operative Complications

Background: Haemorrhoids are the most common benign anorectal problems worldwide. Treatments of third and fourth degree hemorrhoids include surgical haemorrhoidectomy. Milligan Morgan haemorrhoidectomy (MMH) as described in 1937 has remained the most popular among many techniques proposed. In order to avoid the postoperative drawbacks of Milligan Morgan haemorrhoidectomy, a new surgical treatment for prolapsing haemorrhoids has been described by Longo in 1995, procedure called stapled haemorrhoidopexy which is associated with less postoperative pain and a quicker recovery. The objective of this study was to compare the short-term outcome between stapled hemorrhoidopexy and Milligan-Morgan hemorrhoidectomy.Methods: Prospective randomized study of 120 patients with grade 3 and grade 4 haemorrhoids requiring surgical treatment either MMH or SH, 60 in each group for the period of 18 months from June 2014 to November 2015. Post-operative pain, duration of surgery, duration of hospital stays, post-operative complications and time taken to return to work were compared with mean follow up period of 6 months.Results: Duration of surgery is significantly low in stapled group with P <0.001, duration of hospital stay is significantly low in stapled group with P <0.001, post-operative pain low in staple group with P <0.05, time taken to return to work is significantly early in stapled group with P <0.001. Post-operative complications incontinence not found in the present study but recurrence of two cases in each group noted.Conclusion: Stapled hemorrhoidopexy is associated with less postoperative pain, shorter duration of surgery and hospital stay, earlier return to work as compared with Milligan-Morgan open hemorrhoidectomy. The procedure is not associated with major post-operative complications.

STAPLED HEMORRHOIDOPEXY A BETTER AND SAFER ALTERNATIVE TO OPEN HEMORRHOIDECTOMY IN THE MANAGEMENT OF GRADE III & IV HEMORRHOIDS- A HOSPITAL BASED STUDY

2021 ◽  
pp. 39-42
Author(s):  
G.D. Yadav ◽  
Ramendra Kumar Jauhari ◽  
Nishant Saxena ◽  
Firoj Khan ◽  
Sunil Kumar Gupta
Keyword(s):  
Statistical Analysis ◽  
Postoperative Pain ◽  
Hospital Stay ◽  
Stapled Hemorrhoidopexy ◽  
Short Term ◽  
Open Hemorrhoidectomy ◽  
Continuous Scale ◽  
Duration Of Surgery ◽  
Grade 3 ◽  
Grade Iii

Background: Surgical hemorrhoidectomy is usual method for management in hemorrhoid grade III and IV. It is generally associated with postoperative pain, long hospital stay and a longer convalescence. Stapled hemorrhoidopexy is a newer minimally invasive alternative for the treatment of hemorrhoids. Aims: In this study, the above two methods were compared with respect to short term outcomes. Settings and Design: This was a prospective and randomized study. Methods: 60 patients having grade 3 or 4 hemorrhoids and who fullled the criteria were included in the study. Thirty patients underwent stapled hemorrhoidopexy and other thirty underwent open hemorrhoidectomy. All patients were reviewed immediately after surgery and at 1, 3 and6 weeks post-operatively. The two groups were compared in terms of duration of surgery, hospital stay, return to work and post-operative level of satisfaction . Statistical Analysis: The statistical analysis was done using SPSS (Statistical Package for Social Sciences) Version 15.0 statistical Analysis Software. Signicance was assessed at 5% level of signicance. Student t-test was used to nd the signicance of study parameters on continuous scale in parametric condition between two groups (inter group analysis) and Mann Whitney U test was used to nd the signicance of study parameters on continuous scale in non-parametric condition within each group. Chi-square/ Fisher Exact test were used to nd the signicance of study parameters on categorical scale between two groups. Results: The overall mean age of patients in our study was 41.35 ± 12.80. The majority of patients in the study were males (78.3%) and had grade 3 haemorrhoids (93.3%). Stapled hemorrhoidopexy group had shorter duration of surgery, less postoperative pain and need for analgesia, shorter duration of hospital stay and earlier return to work and a high patient satisfaction as compared with open hemorrhoidectomy group. Conclusions: Stapled hemorrhoidopexy is a minimally invasive, better and safer alternative to open hemorrhoidectomy with many short-term benets.

scholarly journals Glyceryl Trinitrate Ointment Did Not Reduce Pain After Stapled Hemorrhoidectomy: A Randomized Controlled Trial

2012 ◽  
Vol 97 (2) ◽  
pp. 112-119 ◽  
Author(s):  
Trent Cross ◽  
Lynne Bartlett ◽  
Chrispen Mushaya ◽  
Mohamed Ashour ◽  
Yik-Hong Ho
Keyword(s):  
Postoperative Pain ◽  
Glyceryl Trinitrate ◽  
Controlled Trial ◽  
Perianal Skin ◽  
Stapled Hemorrhoidopexy ◽  
Control Group ◽  
Stapled Hemorrhoidectomy ◽  
Recurrence Rates ◽  
Skin Tags ◽  
Pain Duration

Abstract Medications, including topical 0.2% glyceryl trinitrate (GTN), can reduce anal spasm and pain after excisional hemorrhoidectomy. GTN after stapled hemorrhoidopexy was compared with routine postoperative management. Patients with symptomatic grade 3/4 hemorrhoids were recruited. After stapled hemorrhoidopexy, residual perianal skin tags were excised as appropriate. Those requiring double purse-string mucosectomy were excluded. Postoperative pain, pain duration, and complications were assessed. One hundred ten patients (74 men; mean age 50.6 years) were enrolled in the control group and 100 patients (57 men; mean age 49.8 years) in the GTN group. Maximum pain was higher in the GTN group (P  =  0.015). There were no differences between the two groups in residual perianal skin tags requiring excision, postoperative complications, recurrence rates, follow-up period, average pain, duration of pain, or satisfaction scores. Sixteen GTN patients were noncompliant due to side effects. None had persistent perianal skin tags. GTN did not reduce postoperative pain after stapled hemorrhoidectomy.

scholarly journals Quality of Life after Stapled Hemorrhoidopexy: A Prospective Observational Study

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Pankaj Kumar Garg ◽  
Gopal Kumar ◽  
Bhupendra Kumar Jain ◽  
Debajyoti Mohanty
Keyword(s):  
Quality Of Life ◽  
Postoperative Pain ◽  
Analogue Scale ◽  
Prospective Observational Study ◽  
Stapled Hemorrhoidopexy ◽  
Study Group ◽  
Alpha Coefficient ◽  
Modest Improvement ◽  
High Internal Consistency

Objective. The objective of the study was to assess the change in quality of life (QOL) of patients undergoing stapled hemorrhoidopexy (SH) using WHO Quality of Life-BREF (WHOQOL-BREF) questionnaire.Methods. The study sample comprised patients with symptomatic II, III, and IV degree hemorrhoids, undergoing SH. The patients were asked to complete WHOQOL-BREF questionnaire before and one month following the surgery.Result. There were 20 patients in the study group. The postoperative pain score measured by visual analogue scale at six hours postoperatively was at 24 hours. The items in the WHOQOL-BREF had high-internal consistency or reliability as shown by high Cronbach's alpha coefficient which was 0.82 and 0.90 for pre- and postoperative questionnaires. There was significant improvement in the overall perception of QOL and health, and in physical and psychological domains. There was modest improvement in environmental domain, while no change was noted in social domain.Conclusion. SH improved the quality of life of patients treated for hemorrhoids.

Stapled Hemorrhoidopexy: Outcome Assessment

2007 ◽  
Vol 73 (7) ◽  
pp. 733-736 ◽  
Author(s):  
Scott D. Goldstein ◽  
Keith P. Meslin ◽  
Thomas Mazza ◽  
Gerald A. Isenberg ◽  
James Fitzgerald ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Rectal Surgery ◽  
Normal Activity ◽  
Hemorrhoidal Disease ◽  
Stapled Hemorrhoidopexy ◽  
Colon And Rectal Surgery ◽  
Surgery Training ◽  
Operative Control ◽  
Grade Ii ◽  
Hemorrhoidal Prolapse

Since its introduction as a new procedure for the surgical management of hemorrhoidal disease in 1993, stapled hemorrhoidopexy has become increasingly popular. This has been mostly the result of the reported reduction in postoperative pain. This study was designed to review retrospectively 152 patients combined from a 3-year period in a three-surgeon private colorectal practice and a 1-year period from an academic colon and rectal surgery training program. All patients had either grade II or III hemorrhoidal prolapse. There were 78 male (mean age, 52 years) and 74 female patients (mean age, 54 years). A total of 133 patients (87.5%) were treated on an ambulatory basis, with 131 patients (86%) given monitored sedation with local anesthesia. Postoperative complications were seen in 49 patients (32%); 33 were for bleeding, with four requiring operative control. Subsequent associated anorectal procedures were performed on 14 patients (9.2%). Of the original 152 patients, 78 participated in a postoperative survey. Of these patients, 67.9 per cent stated that their postoperative pain was less than expected. Seventy-one patients (91%) stated significant improvement or complete resolution of their symptoms, and 73.1 per cent returned to normal activity in less than 2 weeks. Eighty-nine per cent of patients surveyed stated they would recommend hemorrhoidopexy to others.

scholarly journals Stapled hemorrhoidopexy versus open hemorrhoidectomy: a comparative study of short term results

2017 ◽  
Vol 4 (2) ◽  
pp. 472 ◽  
Author(s):  
Idoor D. Sachin ◽  
Om Prakash Muruganathan
Keyword(s):  
Postoperative Pain ◽  
Return To Work ◽  
Hospital Stay ◽  
Stapled Hemorrhoidopexy ◽  
Short Term ◽  
Open Hemorrhoidectomy ◽  
Duration Of Surgery ◽  
The Mean ◽  
Grade 3

Background: Hemorrhoids are usually managed by surgical hemorrhoidectomy which is associated with postoperative pain, long hospital stay and a longer convalescence. Stapled hemorrhoidopexy is a newer alternative for the treatment of hemorrhoids. In this study, the two methods were compared for short term outcomes.Methods: Hundred patients having grade 3 or 4 hemorrhoids and who fulfilled the criteria were included in the study from June 2012 to May 2014. Fifty patients underwent stapled hemorrhoidopexy and other fifty underwent open hemorrhoidectomy. All patients were reviewed immediately after surgery and at 1, 3, 6 weeks and 6 months post-operatively. The two groups were compared for duration of surgery, hospital stay, return to work and post-operative complications.Results: The mean (S.D.) age was 40.06 (10.33) in our study. The majority of patients in the study were males and had grade 4 haemorrhoids. Stapled hemorrhoidopexy group had shorter duration of surgery, less postoperative pain and need for analgesia, shorter duration of hospital stay and earlier return to work and a high patient satisfaction as compared with open hemorrhoidectomy group. There were no major post-operative complications, recurrence, residual prolapse or incontinence in the follow up period of six months in the stapled group.Conclusions: Stapled hemorrhoidopexy is a safer alternative to open hemorrhoidectomy with many short-term benefits.

Concepts for the therapy of postoperative pain

1999 ◽  
Vol 56 (8) ◽  
pp. 460-464 ◽  
Author(s):  
Janson ◽  
Brunne
Keyword(s):  
Postoperative Pain

Eine adäquate Therapie postoperativ auftretender Schmerzen verbessert nicht nur das Wohlbefinden der Patienten, sondern beeinflußt auch die posttraumatische bzw. postoperative Pathophysiologie positiv. Dazu stehen neben der kontinuierlichen bzw. repetitiven Applikation von Antipyretika und Opioiden auch spezielle Methoden wie die intravenöse Patienten-kontrollierte Analgesie (PCA) und die Epiduralanalgesie zur Verfügung. Während bisher allein die Verbesserung der Analgesiequalität im Vordergrund der Bemühungen stand, werden zur Zeit neue Konzepte mit einem multimodalen Ansatz entwickelt. Dabei soll mit Hilfe der Analgesie eine gute Mobilisierbarkeit, ein früher enteraler Kostaufbau und eine insgesamt schnellere Konsolidierung des Patienten mit dem Ziel der Reduktion perioperativer Morbidität und Mortalität erreicht werden.

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