Grotenhuis Brechtje A, Nonner Joost, de Graaf Eelco J R, Doornebosch Pascal G
Dig Surg. 2018;35(5):406-410. doi: 10.1159/000480355. Epub 2017 Nov 2.
Stapled anopexy is a safe technique for the treatment of hemorrhoids but carries a higher risk of recurrence, which might be caused due to the limited volume of resected tissue. In this study, we investigated the introduction of a high-volume circular stapling device; in particular whether an increased amount of resected tissue could affect patients' short-term postoperative outcome.
Between 2011 and 2015, stapled anopexy was performed for hemorrhoids and/or anal prolapse in 141 patients (n = 25 conventional PPH-3©-stapler versus n = 116 high-volume CHEX©-stapler). In this prospectively collected dataset, operation details and short-term postoperative outcome were compared.
With the high-volume stapler, a significantly higher amount of tissue was resected: 9.8 g (range 6.2-11.4) vs. 6.4 g (range 4.9-8.8) with the conventional stapler, p < 0.01. Postoperative short-term outcome did not differ in terms of readmission and complication rates. In all 5 patients who underwent a redo operation for residual hemorrhoids or prolapse, the high-volume stapler was used in the primary operation.
A high-volume stapling device for stapled anopexy was introduced safely with a significantly higher amount of resected tissue without a worse short-term outcome. However, it remains unclear whether higher stapling volumes may lead to improved long-term outcome with less reinterventions.
吻合器痔上黏膜环切术是一种治疗痔疮的安全技术，但复发风险较高，这可能是由于切除组织量有限所致。在本研究中，我们探讨了一种大容量环形吻合器的应用；特别是切除组织量的增加是否会影响患者术后短期结局。
2011年至2015年期间，对141例痔疮和/或肛门脱垂患者实施了吻合器痔上黏膜环切术（25例使用传统PPH-3©吻合器，116例使用大容量CHEX©吻合器）。在这个前瞻性收集的数据集中，比较了手术细节和术后短期结局。
使用大容量吻合器时，切除的组织量显著更多：分别为9.8克（范围6.2 - 11.4克）和6.4克（范围4.9 - 8.8克），p < 0.01。术后短期结局在再入院率和并发症发生率方面没有差异。在所有5例因残留痔疮或脱垂而接受再次手术的患者中，初次手术均使用了大容量吻合器。
安全引入了一种用于吻合器痔上黏膜环切术的大容量吻合器，切除组织量显著增加，且短期结局并未变差。然而，更高的吻合量是否会带来更好的长期结局以及减少再次干预仍不清楚。
