A prospective randomized controlled trial evaluating the short-term outcomes of transanal hemorrhoidal dearterialization versus tissue-selecting technique.
Tech Coloproctol
; 21(9): 737-743, 2017 Sep.
Article
en En
| MEDLINE
| ID: mdl-28932913
BACKGROUND: Tissue-selecting technique (TST) is a novel stapled hemorrhoidectomy technique which targets the hemorrhoids, leaving uninvolved mucosal bridges intact and avoiding circumferential circular stapling. The aim of this study was to compare the short-term outcomes of TST and transanal hemorrhoidal dearterialization (THD). METHODS: Patients presenting with symptomatic hemorrhoids were recruited. Patients were randomized into two groups: (1) TST and (2) THD. Patient demographics, perioperative data, postoperative pain scores, recurrence and patient satisfaction scores were evaluated. Patients with acute thrombosed hemorrhoids, external hemorrhoids only, or other concomitant anal diseases were excluded. RESULTS: From January 2013 to December 2015, 80 patients were included in the study, 40 in each group. There were no significant differences between groups as regards demographic data, perioperative data and postoperative pain scores. The median symptom scores for bleeding and prolapse were significantly lower in the TST group at 1 year (bleeding 1 vs. 2, p = 0.001; prolapse 1 vs. 2, p = 0.025). There was significantly less recurrence requiring reintervention in the TST group (4/40 vs. 17/40, p = 0.001). Satisfaction was significantly greater after TST. The median satisfaction scores after TST and THD were 4 and 3 (on a scale of 1-4; 4 = excellent satisfaction) (p < 0.00001), respectively. CONCLUSIONS: Both THD and TST are safe, and they appear to have similar short-term outcomes; however, TST is associated with better improvement in symptoms, lower recurrence rates and greater patient satisfaction.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Complicaciones Posoperatorias
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Grapado Quirúrgico
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Hemorreoidectomía
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Cirugía Endoscópica Transanal
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Hemorroides
Tipo de estudio:
Clinical_trials
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Etiology_studies
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Observational_studies
Límite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Tech Coloproctol
Asunto de la revista:
GASTROENTEROLOGIA
Año:
2017
Tipo del documento:
Article
Pais de publicación:
Italia