2014

A prospective and comparative study between stapled hemorrhoidopexy and hemorrhoidal artery ligation with mucopexy

Béliard A., Labbé F., de Faucal D., Borie F. et al.
Journal of Visceral Surgery; Volume 151, Issue 4, September 2014, Pages 257-262

AIM:
The aim of this study was to compare the efficacy between stapled hemorrhoidopexy (Longo technique) and transanal hemorrhoidal artery ligation with mucopexy (THDm) in the treatment of hemorrhoidal disease.

PATIENTS & METHODS:
From June 2009 to January 2011, 81 patients having grade II or III hemorrhoidal disease underwent prospective evaluation followed by surgery at two centers (27 Longo and 54 THD). Symptoms (bleeding, tenesmus, prolapse, fecal incontinence, pain) and the satisfaction score were compared on the first post-operative day and at 1, 6, 12, and 24 months thereafter. The follow-up was 24 months.

RESULTS:
There was no difference in mean length of stay. One complication (recto-vaginal fistula) was observed after Longo. The prolapse score was significantly lower after THDm than after Longo on the first post-operative day (P<0.0015). Bleeding score after THDm was significantly lower on the first post-operative day (P=0.04), but higher thereafter (P=0.03 and P=0.04). Tenesmus score after THDm was significantly lower for the first three months (P<0.06 and 0.001). On the first post-operative day and at one month, the visual analog pain score was significantly lower after THDm than that after Longo (P<0.0003 et P<0.01). On the first post-operative day and at one month, the satisfaction score was higher after THDm than after Longo (P<0.001).

CONCLUSIONS:
THD was safe and effective. Short-term outcomes after THDm were better than after Longo but long-term results seemed to be similar.

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