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Technological improvements in the treatment of haemorrhoids and obstructed defaecation syndrome
Giuliano Reboa1, Marco Gipponi, Tommaso Testa
1U.O.C. General Surgery, Colorectal Unit, San Martino Hospital, L.go R. Benzi, 10 - 16132 Genoa, Italy.
Background:
An evolution of CPH34 (CPH34 HV) for stapled transanal rectal resections was developed and tested to assess its safety and resection volume as compared to other staplers.
Materials And Methods:
A total of 16 pigs were randomly assigned to rectal prolapsectomy with CPH34 HV (n=4), CPH34 (n=4), PPH03-33 (n=4), HEEA (n=2) and PPH-01 (n=2). Measures and histological structure of specimens were assessed; transrectal echotomography (ETG) was performed on the third postoperative day, hence pigs were autopsied.
Results:
Significant differences of the volumes and weights of specimens were observed by type of stapler (p=0.0298 and p=0.0278, respectively) which were mainly due to CPH34 HV vs. PPH03-33 (p=0.0402 and p=0.0375, respectively). The average volumes were 17.1% lower for CPH34, 30.2% lower for HEEA, and 34.7% lower for PPH03-33 with respect to CPH34 HV. No significant increase of resection volume (7.5%) was observed between two PPH-01 units combined (two specimens together) vs. a single CPH34 HV unit. The highest percentage of muscularis propria was observed into the specimens collected with CPH34 HV and HEEA (50%). ETG detected three intra- and two extraparietal haematomata.
Conclusion:
The safety and higher volume of resection achievable with CPH34 HV correlated well with the specimen weight and percentage of muscularis propria.
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