Partial stapled hemorrhoidopexy: clinical aspects and impact on anorectal physiology

ABSTRACT Objective: to evaluate the impact of partial stapled hemorrhoidopexy on anorectal physiology, the complications related to this surgical technique, pain, postoperative bleeding and recurrence of hemorrhoidal disease one year after surgery. Methods: this is a prospective, descriptive study in consecutive patients with mixed or internal hemorrhoidal disease, the internal component being classified as grade III or IV, undergoing partial stapled hemorrhoidopexy. Results: we studied 17 patients, 82% of them with internal hemorrhoids grade III and 18% grade IV. The mean operative time was 09:09 minutes (07:03 to 12:13). The median pain in the immediate postoperative period evaluated by the numerical pain scale was one (0 to 7). The median time to return to work was nine days (4 to 19). No patient had anal stenosis and 76% were satisfied with the surgery 90 days postoperatively. When comparing the preoperative manometry data with that measured 90 days after surgery, none of the variables studied showed statistically significant difference. There was no recurrence of hemorrhoidal disease with one year of postoperative follow-up. Conclusion: partial stapled hemorrhoidopexy showed no impact on anorectal physiology, presenting low levels of complications and postoperative pain, without recurrence of hemorrhoidal disease in one year of follow-up.

摘要：目的：评估部分吻合器痔上黏膜环切术（partial stapled hemorrhoidopexy）对肛肠生理的影响、该手术技术相关并发症、术后疼痛、术后出血及术后1年痔病复发情况。方法：本研究为前瞻性描述性研究，纳入连续就诊的混合痔或内痔患者，其内痔部分被分级为Ⅲ度或Ⅳ度，均接受部分吻合器痔上黏膜环切术治疗。结果：本研究共纳入17例患者，其中82%为Ⅲ度内痔，18%为Ⅳ度内痔。平均手术时长为9分09秒（7分03秒至12分13秒）。采用数字疼痛评分法评估的术后即刻疼痛中位数为1分（0~7分）。恢复正常工作的中位时间为9天（4~19天）。无患者出现肛门狭窄，术后90天时76%的患者对手术效果表示满意。将术前肛管测压数据与术后90天的测压结果进行对比，所有研究变量均未出现统计学显著性差异。术后1年随访期间未出现痔病复发。结论：部分吻合器痔上黏膜环切术对肛肠生理无不良影响，并发症及术后疼痛程度均较低，术后1年随访未出现痔病复发。