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Long-Term Outcomes of Sectorial Longitudinal Augmented Prolapsectomy for Asymmetric Muco-hemorrhoidal Prolapse: An Observational Study of 433 Consecutive Patients
- Publication Year :
- 2021
- Publisher :
- SAGE Publications Inc., 2021.
-
Abstract
- Purpose: Hemorrhoidal disease (HD) is a widespread condition severely influencing patients' quality of life. Recently, the large diffusion of stapled hemorrhoidopexy has revealed a new unexpected pathological entity: the asymmetric mucosal prolapse. We aimed to assess the outcomes of the sectorial longitudinal augmented prolapsectomy (SLAP), a technique dedicated to asymmetric prolapse, in terms of HD symptoms, prolapse recurrence, and rectal stenosis. Methods: Patients affected by III-IV-degree symptomatic HD with asymmetric mucosal prolapse undergone SLAP of 1 or 2 hemorrhoidal columns (SLAP1 or SLAP2) were retrospectively assessed. The severity of hemorrhoid symptoms and fecal continence status were evaluated before and after surgery. Mean outcome was evaluation of medium-long-term outcomes as the occurrence of recurrence and anal or rectal stenosis. Secondary outcome was the evaluation of postoperative bleeding, reoperation rate, length of hospitalization, fecal urgency, and time to return to work. Results: We enrolled 433 patients (277 SLAP1 and 156 SLAP2). Hemorrhoidal symptoms recurrence was reported in 9 patients undergone SLAP1 and 4 patients undergone SLAP2, while prolapse recurrence occurred, respectively, in 4 and 2 patients. No major intraoperative complications occurred. An emergency reintervention for postoperative bleeding occurred in 13 cases undergone SLAP1 and in 5 patients treated with SLAP2. Fecal incontinence occurred in 8 and 4 cases of patients treated with SLAP1 and SLAP2. Conclusions: The combination of a simple hemorrhoidectomy to a mucosal rectal prolapsectomy should be part of every coloproctologist background. Promising and satisfying results can be achieved using SLAP for HD associated with asymmetric prolapse. Keywords: asymmetric prolapse; hemorrhoidal disease; hemorrhoidectomy; hemorrhoidopexy; muco-prolapsectomy.
- Subjects :
- medicine.medical_specialty
medicine.medical_treatment
hemorrhoidal disease
030230 surgery
asymmetric prolapse
hemorrhoidectomy
hemorrhoidopexy
muco-prolapsectomy
Hemorrhoids
Hemorrhoidal disease
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
Quality of life
Prolapse
Surgical Stapling
medicine
Long term outcomes
Humans
Retrospective Studies
business.industry
Surgery
Treatment Outcome
030220 oncology & carcinogenesis
Stapled hemorrhoidopexy
Quality of Life
Observational study
business
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....112c547f43cae2279968594139f73b9a