Selective Hemorrhoidal Dearterialization with High Mucopexy in the Surgical Treatment of Hemorrhoidal Disease
| Autor: | Stephanie Drago, Carlos Mateus Rotta, Marjorie Cristina da Cruz Bernardino, Afonso Henrique da Silva e Sousa, Carlos Augusto Real Martinez |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
RC799-869 Transanal hemorrhoidal dearterialization doppler Transanal Endoscopic Surgery Hemorrhoidal disease Hemorrhoids medicine Severe pain Shelf technique ligation transanal endoscopic surgery Surgical treatment hemorrhoids/surgery business.industry hemorrhoidectomy Gastroenterology ultrasonography Diseases of the digestive system. Gastroenterology medicine.disease pulsed Surgery hemorrhoids Hemostasis business |
| Zdroj: | Journal of Coloproctology, Vol 41, Iss 03, Pp 234-241 (2021) Journal of Coloproctology (Rio de Janeiro) v.41 n.3 2021 Journal of Coloproctology (Rio de Janeiro. Online) Sociedade Brasileira de Coloproctologia (SBCP) instacron:SBCP Journal of Coloproctology (Rio de Janeiro), Volume: 41, Issue: 3, Pages: 234-241, Published: 08 NOV 2021 |
| ISSN: | 2317-6423 2237-9363 |
| DOI: | 10.1055/s-0041-1735544 |
| Popis: | The doppler-guided transanal hemorrhoidal dearterialization technique associated with mucopexy is a noninvasive surgical option used to treat hemorrhoidal disease (HD). Objective To compare and analyze the results using a variation of the doppler-guided transanal hemorrhoidal dearterialization technique with the technique of selective hemorrhoidal dearterialization with high mucopexy in the treatment of HD. Method A total of 292 patients who underwent surgical treatment for grade II, III and IV HD from March 2012 to December 2017 were studied. From this total, 110 (37.6%) patients underwent a conventional doppler-guided transanal hemorrhoidal dearterialization with mucopexy (CD), and 182 (62.3%) underwent selective hemorrhoidal dearterialization with high mucopexy (SHeLF). In the group of patients undergoing CD, 4 patients (3.64%) had grade II HD, 82 (74.55%) grade III, and 24 (21.82%) grade IV. In the group submitted to SHeLF, 18 (9.89%) patients had grade II HD, 86 (47.25%) had grade III, and 65 (35.71%) had grade IV. The same surgeon operated all patients under spinal anesthesia. In patients undergoing CD, six arterial branches have been dearterialized, while in patients undergoing SHeLF, the hemorrhoidary nipples submitted to a dearterialization were selected (from 1 to 5) by intraoperative evaluation followed by high rectal mucopexy. In the postoperative period, the following parameters were evaluated: pain, tenesmus, bleeding, and recurrence.Moderate results to severe pain was a postoperative complaint reported by 13 (11.82%) patients undergoing CD, and by 19 (10.44%) undergoing SHeLF. Intense tenesmus was reported by 26 (23.64%) patients undergoing CD and by 7 (3.85%) undergoing SHeLF. Three patients (2.73%) undergoing CD and 1 (0.55%) undergoing SHeLF evolved with postoperative bleeding. One patient (0.55%) in the group undergoing CD required surgical review of hemostasis. Six patients (5.45%) who underwent CD and 8 (4.39%) who underwent SHeLF were reoperated due to disease recurrence. Conclusion Comparing statistics, patients undergoing the SHeLF technique have less postoperative pain, tenesmus and postoperative bleeding when compared with CD. |
| Databáze: | OpenAIRE |
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