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Rectal Distensibility and Symptoms After Stapled and Milligan–Morgan Operation for Hemorrhoids

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery

Abstract

Introduction

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.

Methods

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.

Results

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.

Conclusions

Rectal distensibility and volume thresholds for sensations decrease after stapled hemorrhoidopexy. Altered rectal distensibility was associated with rectal urgency and/or increased stool frequency.

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Authors and Affiliations

  1. Division of Gastroenterology and Gastrointestinal Endoscopy, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Via Olgettina 58, 20132, Milan, Italy

    Maura Corsetti, Salvatore Di Pietro, Sandro Passaretti & Pier Alberto Testoni

  2. Department of Surgery, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Via Olgettina 58, 20132, Milan, Italy

    Paola De Nardi & Carlo Staudacher

Authors
  1. Maura Corsetti
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  2. Paola De Nardi
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  3. Salvatore Di Pietro
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  4. Sandro Passaretti
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  5. Pier Alberto Testoni
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  6. Carlo Staudacher
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Correspondence to Maura Corsetti.

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Corsetti, M., De Nardi, P., Di Pietro, S. et al. Rectal Distensibility and Symptoms After Stapled and Milligan–Morgan Operation for Hemorrhoids. J Gastrointest Surg 13, 2245–2251 (2009). https://doi.org/10.1007/s11605-009-0983-7

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  • DOI: https://doi.org/10.1007/s11605-009-0983-7

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