Rectal Distensibility and Symptoms After Stapled and Milligan–Morgan Operation for Hemorrhoids
- 138 Downloads
In a previous uncontrolled study, a reduction of rectal distensibility and volume thresholds for sensations have been related to the occurrence of fecal urgency and/or increased stool frequency after stapled hemorrhoidopexy.
Aim of the study
The aim of this study was to compare rectal symptoms and sensory-motor function after stapled hemorrhoidopexy and Milligan–Morgan hemorrhoidectomy.
The clinical records of 12 (four women) and ten patients (four women) with third- and fourth-degree hemorrhoids, respectively, who underwent stapled hemorrhoidopexy or Milligan–Morgan’s hemorrhoidectomy, were evaluated. One week before and 6 months after surgery, rectal motor and sensory response to distension was assessed by an electronic barostat, and bowel and rectal symptoms were recorded by means of a 7-day diary and Bristol Index scale and psychological symptoms with SCL-90 questionnaire.
Rectal distensibility and volume thresholds for sensations were significantly lower after surgery (P < 0.02) in the stapled group. Increased stool frequency and/or fecal urgency arose in 41% of patients in the stapled group and associated with altered rectal distensibility. No difference within and between groups could be demonstrated in SCL-90 score.
Rectal distensibility and volume thresholds for sensations decrease after stapled hemorrhoidopexy. Altered rectal distensibility was associated with rectal urgency and/or increased stool frequency.
KeywordsHemorrhoids Barostat Rectal motor function Rectal sensory function Postoperative symptoms
- 6.Correa-Rovelo JM, Tellez O, Obregon L, Duque-Lopez X, Miranda-Gomez A, Pichardo-Bahena R, Mendez M, Moran S. Prospective study of factors affecting postoperative pain and symptom persistence after stapled rectal mucosectomy for hemorroids: a need for preservation of squamous epithelium. Dis Colon Rectum 2003;46:955–962.CrossRefPubMedGoogle Scholar
- 9.Derogatis LR, Melisaratos N. The brief symptom inventory: an introductory report. Physiol Med 1983;13:595–605.Google Scholar
- 11.Longo A. Treatment of hemorrhoidal disease by reduction of mucosa and hemorrhoidal prolapse with a circular stapling device: a new procedure. Proceedings of the 6th World Congress of Endoscopic Surgery, June 3, 1998. Monduzzi Editore, 1998.Google Scholar
- 35.Corman ML, Gravie JF, Hager T, Loudon MA, Mascagni D, Nystrom P-O, Seow-Choen F, Abcarian H, Marcello P, Weiss E, Longo A. Stapled haemorrhoidopexy: a consensus position paper by an international working party—indications, contra-indications and technique. Colorectal Disease 2003;5:30410.Google Scholar