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Transanale offene Hämorrhoidopexie

Gute Ergebnisse nach 8 Jahren Nachbeobachtung

Transanal open hemorrhoidopexy

Good results after a follow-up of 8 years

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  • Published:
coloproctology Aims and scope

Zusammenfassung

Ziel

Untersuchung des Langzeiterfolges nach transanaler offener Hämorrhoidopexie nach einer Nachbeobachtungszeit von mindestens 8 Jahren.

Methode

Alle Patienten wurden in unserer Einrichtung operiert. Von 148 Patienten, die vor mehr als 8 Jahren operiert worden waren, konnten 110 erreicht werden und waren fähig, einen Fragebogen auszufüllen.

Ergebnisse

Es waren keine perioperativen Komplikationen aufgetreten. Die Nachbeobachtungszeit betrug mindestens 97 Monate (im Median 123,4 Monate). Operationsindikation waren symptomatische zweit- oder drittgradige Hämorrhoiden. Häufigste Symptome waren Blutung (n = 89) und Fremdkörpergefühl (n = 50). Unmittelbar postoperativ waren die Symptome bei 80 Patienten (72,7 %) deutlich gebessert oder vollständig verschwunden. Zum Zeitpunkt der Nachuntersuchung hatten 71 Patienten (64,5 %) keine Beschwerden, 38 Patienten (34,5 %) hatten Beschwerden. 96 Patienten (87,3 %) gaben an, sich wieder für die transanale offene Hämorrhoidopexie zu entscheiden, während 12 Patienten (10,9 %) das nicht tun würden. Bei 25 Patienten (22,7 %) war eine weitere Operation durchgeführt worden, bei 14 davon eine erneute Hämorrhoidopexie.

Schlussfolgerung

Nach mehr als 8 Jahren Nachbeobachtung waren zwei Drittel der Patienten beschwerdefrei. 25 Patienten (22,7 %) wurden ein weiteres Mal operiert. Die transanale offene Hämorrhoidopexie ist eine sichere Operation mit ermutigenden Langzeitergebnissen und sollte in den Therapiealgorithmus zur Behandlung des symptomatischen Hämorrhoidalleidens einbezogen werden.

Abstract

Aim

To investigate the long-term success after transanal open hemorrhoidopexy after a follow-up period of at least 8 years

Methods

All patients were operated on at our office. Of 148 patients who underwent surgery more than 8 years ago, 110 were reached and were able to complete a questionnaire.

Results

There were no perioperative complications. The follow-up period was at least 97 months (median 123.4 months). Surgical indications were symptomatic second- or third-degree hemorrhoids. The most common symptoms were bleeding (n = 89) and foreign body sensation (n = 50). Immediately postoperatively, the symptoms were significantly improved or completely disappeared in 80 patients (72.7%). At the time of follow-up, 71 patients (64.5%) had no complaints and 38 patients (34.5%) had complaints. Ninety-six patients (87.3%) indicated that they would choose transanal open hemorrhoidopexy again, while 12 patients (10.9%) would not do so. In 25 patients (22.7%) another operation had been performed, in 14 of them a new hemorrhoidopexy.

Conclusion

After more than 8 years of follow-up, two-thirds of patients were symptom-free. Twenty-five patients (22.7%) underwent further surgery. Transanal open hemorrhoidopexy is a safe operation with encouraging long-term results and should be included in the treatment algorithm for symptomatic hemorrhoidal disease.

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Literatur

  1. Thomson WH (1975) The nature of haemorrhoids. Br J Surg 62(7):542–552

    Article  CAS  Google Scholar 

  2. Lohsiriwat V (2012) Hemorrhoids: from basic pathophysiology to clinical management. World J Gastroenterol 18(17):2009–2017

    Article  CAS  Google Scholar 

  3. Barron J (1963) Office ligation of internal hemorrhoids. Am J Surg 105:563–570

    Article  CAS  Google Scholar 

  4. Neiger A (1978) Hemorrhoids: recognition and current therapeutic possibilities. Schweiz Med Wochenschr 108(13):500–504

    CAS  PubMed  Google Scholar 

  5. Anderson HG (1924) The treatment of haemorrhoids by submucous injections of chemicals. Br Med J 2(3316):100–102

    Article  CAS  Google Scholar 

  6. Longo A (2002) Stapled anopexy and stapled hemorrhoidectomy: two opposite concepts and procedures. Dis Colon Rectum 45(4):571–572

    Article  Google Scholar 

  7. Pakravan F, Helmes C, Baeten C (2009) Transanal open hemorrhoidopexy. Dis Colon Rectum 52(3):503–506

    Article  CAS  Google Scholar 

  8. Theodoropoulos GE et al (2010) Doppler-guided haemorrhoidal artery ligation, rectoanal repair, sutured haemorrhoidopexy and minimal mucocutaneous excision for grades III–IV haemorrhoids: a multicenter prospective study of safety and efficacy. Colorectal Dis 12(2):125–134

    Article  CAS  Google Scholar 

  9. Zagriadskii EA (2013) Transanal Doppler-guided desarterization with mucopexy (HAL-RAR) for the treatment of hemorrhoids stage III–IV. Khirurgiia (Mosk) 4:59–64

    Google Scholar 

  10. Morinaga K, Hasuda K, Ikeda T (1995) A novel therapy for internal hemorrhoids: ligation of the hemorrhoidal artery with a newly devised instrument (Moricorn) in conjunction with a Doppler flowmeter. Am J Gastroenterol 90(4):610–613

    CAS  PubMed  Google Scholar 

  11. Kobladin SN, Schalkow JL (1981) Eine neue Methode zur Behandlung von Hämorrhoiden mit Hilfe eines Zirkularstaplers. Wissenschaftliches Archiv des Zelinograder Medizinischen Institutes, Kasachstan, S 27–28

    Google Scholar 

  12. Longo A (1995) Mechanical hemorrhoidectomy using a circular stapler. Refresher course on hemorrhoidal disease therapy. 24th International Congress of Latin Mediterranean, Palermo

    Google Scholar 

  13. Ratto C (2014) THD Doppler procedure for hemorrhoids: the surgical technique. Tech Coloproctol 18(3):291–298

    Article  CAS  Google Scholar 

  14. Ratto C et al (2012) Assessment of haemorrhoidal artery network using colour duplex imaging and clinical implications. Br J Surg 99(1):112–118

    Article  CAS  Google Scholar 

  15. Aigner F et al (2016) Doppler-guided haemorrhoidal artery ligation with suture mucopexy compared with suture mucopexy alone for the treatment of grade III haemorrhoids: a prospective randomized controlled trial. Colorectal Dis 18(7):710–716

    Article  CAS  Google Scholar 

  16. Senagore AJ et al (2004) A prospective, randomized, controlled multicenter trial comparing stapled hemorrhoidopexy and Ferguson hemorrhoidectomy: perioperative and one-year results. Dis Colon Rectum 47(11):1824–1836

    Article  CAS  Google Scholar 

  17. De Nardi P et al (2014) A prospective, randomized trial comparing the short- and long-term results of doppler-guided transanal hemorrhoid dearterialization with mucopexy versus excision hemorrhoidectomy for grade III hemorrhoids. Dis Colon Rectum 57(3):348–353

    Article  Google Scholar 

  18. Ganio E et al (2007) Long-term outcome of a multicentre randomized clinical trial of stapled haemorrhoidopexy versus Milligan-Morgan haemorrhoidectomy. Br J Surg 94(8):1033–1037

    Article  CAS  Google Scholar 

  19. Kim JS et al (2013) Stapled hemorrhoidopexy versus Milligan-Morgan hemorrhoidectomy in circumferential third-degree hemorrhoids: long-term results of a randomized controlled trial. J Gastrointest Surg 17(7):1292–1298

    Article  Google Scholar 

  20. Bhatti MI, Sajid MS, Baig MK (2016) Milligan-Morgan (open) versus Ferguson haemorrhoidectomy (closed): a systematic review and meta-analysis of published randomized, controlled trials. World J Surg 40(6):1509–1519. https://doi.org/10.1007/s00268-016-3419-z

    Article  PubMed  Google Scholar 

  21. Shanmugam V et al (2005) Rubber band ligation versus excisional haemorrhoidectomy for haemorrhoids. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.cd005034.pub2

    Article  PubMed  Google Scholar 

  22. Simillis C et al (2015) Systematic review and network meta-analysis comparing clinical outcomes and effectiveness of surgical treatments for haemorrhoids. Br J Surg 102(13):1603–1618

    Article  CAS  Google Scholar 

  23. Jayaraman S, Colquhoun PH, Malthaner RA (2006) Stapled versus conventional surgery for hemorrhoids. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.cd005393.pub2

    Article  PubMed  Google Scholar 

  24. Brown SR et al (2016) Haemorrhoidal artery ligation versus rubber band ligation for the management of symptomatic second-degree and third-degree haemorrhoids (HubBLe): a multicentre, open-label, randomised controlled trial. Lancet 388(10042):356–364

    Article  Google Scholar 

  25. Burch J et al (2009) Stapled haemorrhoidopexy for the treatment of haemorrhoids: a systematic review. Colorectal Dis 11(3):233–243

    Article  CAS  Google Scholar 

  26. Nisar PJ et al (2004) Stapled hemorrhoidopexy compared with conventional hemorrhoidectomy: systematic review of randomized, controlled trials. Dis Colon Rectum 47(11):1837–1845

    Article  Google Scholar 

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Authors and Affiliations

  1. Coloproktologisches Zentrum Düsseldorf, Schadowstr. 11b, 40212, Düsseldorf, Deutschland

    F. Pakravan, C. Helmes & I. Alldinger

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  1. F. Pakravan
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  2. C. Helmes
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  3. I. Alldinger
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Correspondence to F. Pakravan.

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Interessenkonflikt

F. Pakravan, C. Helmes und I. Alldinger geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Pakravan, F., Helmes, C. & Alldinger, I. Transanale offene Hämorrhoidopexie. coloproctology 40, 352–356 (2018). https://doi.org/10.1007/s00053-018-0283-3

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