J Korean Surg Soc.
2002 May;62(5):430-434.
Clinical Results of Conventional Versus Circular Stapled Hemorrhoidectomy
- Affiliations
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- 1Gastrointestinal Center, Samsung Medical Center, Sungkyunkawan University School of Medicine, Seoul, Korea. hkchun@samsung.co.kr
- 2Department of Surgery, Samsung Medical Center, Sungkyunkawan University School of Medicine, Seoul, Korea.
Abstract
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PURPOSE: A circular stapled hemorrhoidectomy involves the simultaneous excision of hemorrhoids and wound closure without perianal dissection, thereby eliminating a potential contamination of the anal wound. This study was designed to investigate whether a closed hemorrhoidectomy using the circular stapled technique offers any advantage over the conventional technique.
METHODS
Twenty-three patients with prolapsed symptomatic hemorrhoids were treated by either a conventional (n=13) (conventional group) or a circular stapled (n=11) hemorrhoidectomy (stapled group). The operation time was recorded and the excised tissue was examined histologically. The pain score, any complications, the number of days before returning to normal activity and the patients' satisfaction were recorded. A follow up was done using a questionnaire or by telephone interview a week after the operation, and satisfaction was checked a month after the operation.
RESULTS
The conventional operation was quicker to perform (mean 23.1 min vs 26.8 min), but did not reach a significant value (P>0.05). In the stapled group, the analgesic requirement was less than for the conventional group (4.4 times vs 6.9 times), but again did not reach a significant value (P>0.05). There were 4 cases of postoperative complications in the conventional group (30.7%) and 3 cases in the stapled group (27.3%) with no significant difference between two groups (P>0.05). The mean pain score was lower in the stapled group (3.5 vs 4.8)(P<0.05). The stapled group returned to normal activity sooner (13.7 days vs 24.4 days) (P<0.05). The patients' satisfaction was the same for the two groups (conventional group 69.2% vs stapled group 81.8%) (P>0.05).
CONCLUSION
A circular stapled hemorrhoidectomy is an effective treatment for third and forth degree prolapsed hemorrhoids, offering the significant advantages of reduced postoperative pain and an earlier return to normal activity.
