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[Haemorrhoidectomy: conventional excision versus resection with the circular stapler. Prospective, randomized study].

C Hasse1, H Sitter, M Brune

  • 1Klinik für Visceral-, Thorax- und Gefässchirurgie, Philipps-Universität Marburg. coloproktologie@t-online.de

Deutsche Medizinische Wochenschrift (1946)
|July 17, 2004
PubMed
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Stapler haemorrhoidectomy offers reduced pain and faster recovery for stage 3 hemorrhoids compared to conventional methods. While effective long-term, potential complications like incontinence require careful consideration.

Area of Science:

  • Colorectal Surgery
  • Surgical Innovation
  • Gastroenterology

Background:

  • Hemorrhoids are a common condition requiring effective treatment.
  • Surgical intervention is often necessary for advanced stages (Stage 3).
  • Comparing wound-closure techniques is crucial for optimizing outcomes.

Purpose of the Study:

  • To compare stapler hemorrhoidectomy with conventional closed hemorrhoidectomy for Stage 3 hemorrhoids.
  • To evaluate postoperative pain, recovery time, long-term efficacy, and complications.
  • To assess the cost-effectiveness of each surgical method.

Main Methods:

  • Randomized controlled trial involving 80 patients with Stage 3 hemorrhoids.
  • Patients were assigned to either stapler hemorrhoidectomy (n=40) or conventional hemorrhoidectomy (n=40).

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  • Postoperative outcomes were assessed at multiple time points up to one year, including pain, return to work, and complications. Cost analysis was also performed.

    • Main Results:

    • Stapler hemorrhoidectomy resulted in significantly less early postoperative pain and earlier return to work.
    • Long-term (1 year) efficacy showed 84.2% cure rate for stapler hemorrhoidectomy.
    • Complications, including postoperative bleeding, anal incontinence, and voiding disturbances, were observed, with some occurring more frequently in the stapler group, particularly in older patients.

    Conclusions:

    • Stapler hemorrhoidectomy provides a cost-effective, long-term solution for Stage 3 hemorrhoids with reduced early postoperative morbidity.
    • Careful patient selection and monitoring are necessary due to potential complications such as anal incontinence and voiding issues.
    • The procedure demonstrates a favorable long-term cure rate compared to conventional methods.