Skip to main content

Advertisement

SpringerLink
Log in

Long-term outcomes after circular stapled hemorrhoidopexy versus Ferguson hemorrhoidectomy

  • Original Article
  • Published:
Techniques in Coloproctology Aims and scope Submit manuscript

Abstract

Background

We aimed to compare long-term outcomes and quality of life in patients undergoing circular stapled hemorrhoidopexy to those who had Ferguson hemorrhoidectomy.

Methods

Patients who underwent Ferguson hemorrhoidectomy and circular stapled hemorrhoidopexy between 2000 and 2010 were reviewed. Long-term follow-up was assessed with questionnaires.

Results

Two hundred seventeen patients completed the questionnaires. Mean follow-up was longer in the Ferguson hemorrhoidectomy subgroups (7.7 ± 3.4 vs. 6.3 ± 2.9 years, p = 0.003). Long-term need for additional surgical or medical treatment was similar in the Ferguson hemorrhoidectomy and circular stapled hemorrhoidopexy groups (3 vs. 5 %, p = 0.47 and 3 % in both groups, p > 0.99, respectively). Eighty-one percentage of Ferguson hemorrhoidectomy and 83 % of circular stapled hemorrhoidopexy patients stated that they would undergo hemorrhoid surgery again if needed (p = 0.86). The symptoms were greatly improved in the majority of patients (p = 0.06), and there was no difference between the groups as regards long-term anorectal pain (p = 0.16). The Cleveland global quality of life, fecal incontinence severity index, and fecal incontinence quality of life scores were similar (p > 0.05).

Conclusions

This is one of the longest follow-up studies comparing the outcomes after circular stapled hemorrhoidopexy and Ferguson hemorrhoidectomy. Patient satisfaction, resolution of symptoms, quality of life, and functional outcome appear similar after circular stapled hemorrhoidopexy and Ferguson hemorrhoidectomy in long term.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Bleday R, Pena JP, Rothenberger DA, Goldberg SM, Buls JG (1992) Symptomatic hemorrhoids: current incidence and complications of operative surgery. Dis Colon Rectum 35:477–481

    Article  CAS  PubMed  Google Scholar 

  2. MacRae HM, McLeod RS (1997) Comparison of hemorrhoidal treatments: a meta-analysis. Can J Surg 40:14–17

    PubMed Central  CAS  PubMed  Google Scholar 

  3. Ooi BS, Ho YH, Tang CL, Eu KW, Seow-Choen F (2002) Results of stapling and conventional hemorrhoidectomy. Tech Coloproctol 6:61–62 (author reply 61–62)

    Google Scholar 

  4. Longo A (1998) Treatment of hemorrhoidal disease by reduction of mucosal and hemorrhoidal prolapse with circular suturing device: a new procedure. In: Proceedings of the 6th world congress of endoscopic surgery. Bologna, Monduzzi Editore, pp 777–784

  5. Nisar PJ, Acheson AG, Neal KR (2004) Stapled hemorrhoidopexy compared with conventional hemorrhoidectomy: systemic review of randomized, controlled trials. Dis Colon Rectum 47:1837–1845

    Article  PubMed  Google Scholar 

  6. Lau P, Wu X, Zhou X, Wang J, Zhang L (2006) The safety and efficacy of stapled hemorrhoidectomy in the treatment of hemorrhoids: a systematic review and meta-analysis of ten randomized control trials. Int J Colorectal Dis 21:172–178

    Article  Google Scholar 

  7. Jayaraman S, Colquhoun PH, Malthaner RA (2007) Stapled hemorrhoidopexy is associated with a higher long-term recurrence rate of internal hemorrhoids compared with conventional excisional hemorrhoid surgery. Dis Colon Rectum 50:1297–1305

    Article  PubMed  Google Scholar 

  8. Laughlan K, Jayne DG, Jackson D, Rupprecht F, Ribaric G (2009) Stapled haemorrhoidopexy compared to Milligan–Morgan and Ferguson haemorrhoidectomy: a systematic review. Int J Colorectal Dis 24:335–344

    Article  CAS  PubMed  Google Scholar 

  9. Shao WJ, Li GC, Zhang ZH, Yang BL, Sun GD, Chen YQ (2008) Systematic review and metaanalysis of randomized controlled trials comparing stapled haemorrhoidopexy with conventional haemorrhoidectomy. Br J Surg 95:147–160

    Article  PubMed  Google Scholar 

  10. Sutherland LM, Burchard AK, Matsuda K et al (2002) A systematic review of stapled hemorrhoidectomy. Arch Surg 137:1395–1407

    Article  CAS  PubMed  Google Scholar 

  11. Tjandra JJ, Chan MK (2007) Systematic review on the procedure for prolapse and hemorrhoids (stapled hemorrhoidopexy). Dis Colon Rectum 50:878–892

    Article  PubMed  Google Scholar 

  12. Senagore AJ, Singer M, Abcarian H, Procedure for Prolapse and Hemmorrhoids (PPH) Multicenter Study Group et al (2004) Procedure for Prolapse and Hemmorrhoids (PPH) Multicenter Study Group: a prospective, randomized, controlled multicenter trial comparing stapled hemorrhoidopexy and Ferguson hemorrhoidectomy: perioperative and one-year results. Dis Colon Rectum 47:1824–1836

    Article  CAS  PubMed  Google Scholar 

  13. Fazio VW, O’Riordain MG, Lavery IC et al (1999) Long-term functional outcome and quality of life after stapled restorative proctocolectomy. Ann Surg 230:575–586

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  14. Rockwood TH, Church JM, Fleshman JW et al (1999) Patient and surgeon ranking of the severity of symptoms associated with fecal incontinence: the fecal incontinence severity index. Dis Colon Rectum 42:1525–1532

    Article  CAS  PubMed  Google Scholar 

  15. Rockwood TH, Church JM, Fleshman JW et al (2000) Fecal Incontinence Quality of Life Scale: quality of life instrument for patients with fecal incontinence. Dis Colon Rectum 43:9–17

    Article  CAS  PubMed  Google Scholar 

  16. Cheetham MJ, Mortensen NJ, Nystrom PO, Kamm MA, Phillips RK (2000) Persistent pain and faecal urgency after stapled haemorrhoidectomy. Lancet 356:730–733

    Article  CAS  PubMed  Google Scholar 

  17. Khubchandani I, Fealk MH, Reed JF 3rd (2009) Is there a post-PPH syndrome? Tech Coloproctol 13:141–144

    Article  CAS  PubMed  Google Scholar 

  18. Arroyo A, Pérez-Legaz J, Miranda E et al (2011) Long-term clinical results of double-pursestring stapled hemorrhoidopexy in a selected group of patients for the treatment of chronic hemorrhoids. Dis Colon Rectum 54:609–614

    Article  PubMed  Google Scholar 

  19. Ortiz H, Marzo J, Armendariz P (2002) Randomized clinical trial of stapled haemorrhoidopexy versus conventional diathermy haemorrhoidectomy. Br J Surg 89:1376–1381

    Article  CAS  PubMed  Google Scholar 

  20. Ommer A, Hinrichs J, Möllenberg H (2011) Long-term results after stapled hemorrhoidopexy: a prospective study with a 6-year follow-up. Dis Colon Rectum 54:601–608

    Article  CAS  PubMed  Google Scholar 

  21. Gao XH, Fu CG, Nabieu PF (2010) Residual skin tags following procedure for prolapse and hemorrhoids: differentiation from recurrence. World J Surg 34:344–352

    Article  PubMed  Google Scholar 

  22. Guenin MO, Rosenthal R, Kern B, Peterli R, von Flüe M, Ackermann C (2005) Ferguson hemorrhoidectomy: long-term results and patient satisfaction after Ferguson’s hemorrhoidectomy. Dis Colon Rectum 48:1523–1527

    Article  PubMed  Google Scholar 

  23. Kiran RP, Delaney CP, Senagore AJ et al (2003) Prospective assessment of Cleveland Global Quality of Life (CGQL) as a novel marker of quality of life and disease activity in Crohn’s disease. Am J Gastroenterol 98:1783–1789

    Article  PubMed  Google Scholar 

  24. Zbar AP (2009) Re: measurement of anal cushions in idiopathic faecal incontinence. Br J Surg 96:1373–1374

    Article  CAS  PubMed  Google Scholar 

  25. Gibbons CP, Trowbridge EA, Bannister JJ, Read NW (1986) Role of anal cushions in maintaining continence. Lancet 1:886–888

    Article  CAS  PubMed  Google Scholar 

  26. Thekkinkattil DK, Dunham RJ, O’Herlihy S, Finan PJ, Sagar PM, Burke DA (2009) Measurement of anal cushions in idiopathic faecal incontinence. Br J Surg 96:680–684

    Article  CAS  PubMed  Google Scholar 

  27. Jayaraman S, Colquhoun PH, Malthaner RA (2006) Stapled versus conventional surgery for hemorrhoids. Cochrane Database Syst Rev 4:CD005393

    PubMed  Google Scholar 

  28. Yeo D, Tan KY (2014) Hemorrhoidectomy: making sense of the surgical options. World J Gastroenterol 20:16976–16983

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Acknowledgments

This study was supported by the Ed and Joey Story Endowed Chair in Colorectal Surgery. Erman Aytac is an assistant professor of surgery at the Acibadem University School of Medicine in Istanbul, Turkey.

Author information

Authors and Affiliations

  1. Department of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, 9500 Euclid Ave. A30, Cleveland, OH, 44195, USA

    E. Aytac, E. Gorgun, H. H. Erem, M. A. Abbas, T. L. Hull & F. H. Remzi

Authors
  1. E. Aytac
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. E. Gorgun
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. H. H. Erem
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. A. Abbas
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. T. L. Hull
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. F. H. Remzi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to E. Gorgun.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

Ethics committee, Institutional Review Board, Cleveland Clinic Foundation, Cleveland, Ohio, USA.

Informed consent

A waiver of consent was obtained from the Institutional Review Board.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Aytac, E., Gorgun, E., Erem, H.H. et al. Long-term outcomes after circular stapled hemorrhoidopexy versus Ferguson hemorrhoidectomy. Tech Coloproctol 19, 653–658 (2015). https://doi.org/10.1007/s10151-015-1366-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10151-015-1366-6

Keywords

Search

Navigation