Lord's procedure for haemorrhoids: a prospective anal pressure study

Area of Science:

• Colorectal Surgery
• Gastroenterology
• Surgical Outcomes

Background:

• Lord's procedure is a common surgical treatment for hemorrhoids.
• Understanding long-term efficacy and predictors of success is crucial for patient management.

Purpose of the Study:

• To prospectively evaluate the long-term results of Lord's procedure.
• To assess the relationship between preoperative anal pressures and clinical outcomes.
• To investigate the impact of the procedure on anal sphincter pressure over time.

Main Methods:

• Prospective study of 48 patients undergoing Lord's procedure.
• Preoperative and serial postoperative anal pressure recordings over 5+ years.
• Correlation of pressure measurements with clinical outcomes and recurrence.

Main Results:

• Excellent long-term results for first and second-degree hemorrhoids.
• Symptom relief in under 50% of third-degree hemorrhoid patients.
• Significant reduction in anal pressure post-dilatation, remaining stable for 5 years.
• Five patients experienced recurrence between 1-5 years post-procedure.
• No clear prediction of relapse from serial pressure measurements.

Conclusions:

• Lord's procedure is highly effective for early-stage hemorrhoids.
• Efficacy is limited in third-degree hemorrhoids, necessitating further treatment considerations.
• While anal pressure decreases post-procedure, this does not reliably predict recurrence.
• Serial pressure measurements are not predictive of long-term relapse after Lord's procedure.