Department for Surgery and Center for Minimally Invasive Surgery, Kliniken Essen-Mitte, Evang. Huyssens-Stiftung, Essen, Germany.
Dis Colon Rectum. 2011 May;54(5):601-8. doi: 10.1007/DCR.0b013e3182098df2.
Stapled hemorrhoidopexy was introduced in 1998 as a new technique for treating advanced hemorrhoidal disease. Despite a clear perioperative advantage regarding pain and patient comfort, literature reviews indicate a higher recurrence rate for stapled hemorrhoidopexy than for conventional techniques.
Our aim was to present long-term on the use of this technique.
Observational study.
Consecutive patients with hemorrhoid prolapse treated at a regional surgical center from May 27, 1999, through December 31, 2003.
Stapled hemorrhoidopexy with accompanying resection of residual hemorrhoidal nodules if necessary.
Standardized patient questionnaire regarding satisfaction, resolution of symptoms, and performance of further interventions.
Of 257 patients (82 female, 175 male, mean age 53 ± 13 years) undergoing stapled hemorrhoidopexy, follow-up data were available for 224 patients (87.2%) with a mean duration of 6.3 ± 1.2 years. Of these, 195 patients (87.1%) were satisfied or very satisfied with the operation outcome; 19 patients (8.5%) were moderately satisfied; and 10 (4.5%) were not satisfied. Regarding preoperative anal symptoms, complete relief was observed in 179 patients (80.6%) for prolapse, 172 (77.5%) for bleeding, 139 (85.3%) for mucus discharge, 139 (78.5%) for burning sensation, and 115 (75.5%) for itching. Considering all recorded symptoms, 194 patients (86.6%) reported absence and or an improvement at follow-up. Twelve patients (5.4%) reported newly developed incontinence in the sense of urge symptoms; 42 patients out of 51 patients (82.4%) with preexisting incontinence reported an improvement. Local or topical retreatment (ointment, suppositories, sclerotherapy) was performed in 48 patients (21.4%). Reoperation for residual or newly developed hemorrhoidal nodules was needed in 8 patients (3.6%).
Lack of a comparative group.
Our long-term results show that this strategy for stapled hemorrhoidopexy can achieve a high level of patient satisfaction and symptom control, with a low rate of reoperation for recurrent hemorrhoidal symptoms.
吻合器痔上黏膜环切术于 1998 年作为一种治疗中重度痔的新技术推出。尽管在疼痛和患者舒适度方面具有明显的围手术期优势，但文献综述表明吻合器痔上黏膜环切术的复发率高于传统技术。
我们旨在介绍该技术的长期应用效果。
观察性研究。
2003 年 5 月 27 日至 12 月 31 日，在一个区域性外科中心连续接受痔脱垂治疗的患者。
吻合器痔上黏膜环切术，如有必要，同时切除残余痔结节。
标准化患者问卷，包括满意度、症状缓解情况以及进一步干预措施的执行情况。
257 例患者（82 例女性，175 例男性，平均年龄 53 ± 13 岁）接受吻合器痔上黏膜环切术，224 例（87.2%）患者获得随访，平均随访时间 6.3 ± 1.2 年。其中，195 例（87.1%）患者对手术结果满意或非常满意；19 例（8.5%）患者满意程度为中等；10 例（4.5%）患者不满意。术前肛门症状方面，179 例（80.6%）患者脱垂完全缓解，172 例（77.5%）患者出血缓解，139 例（85.3%）患者黏液排出缓解，139 例（78.5%）患者烧灼感缓解，115 例（75.5%）患者瘙痒缓解。考虑所有记录的症状，194 例（86.6%）患者在随访时报告无任何症状或症状改善。12 例（5.4%）患者报告新出现急迫症状的失禁；51 例有术前失禁的患者中，42 例（82.4%）报告症状改善。48 例（21.4%）患者行局部或局部治疗（软膏、栓剂、硬化剂）。8 例（3.6%）患者因残余或新出现的痔结节需要再次手术。
缺乏对照组。
我们的长期结果表明，这种吻合器痔上黏膜环切术策略可以达到较高的患者满意度和症状控制水平，且因复发痔症状而再次手术的发生率较低。
