Circular Mucosal Anopexy: Experience and Technical Considerations

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• 作者：Luis Antonio Hidalgo Grau ; Neus Ruiz Edo ; ^{neus.ruiz.edo@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Sara Llorca Carde&ntilde ; osa ; Adolfo Heredia Budó ; Ó ; scar Estrada Ferrer ; Marta del Bas Rubia ; Eva Marí ; a Garcí ; a Torralbo ; Xavier Su&ntilde ; ol Sala
• 关键词：Hemorrhoids ; Rectal mucosal prolapse ; Circular mucosal anopexy
• 刊名：Cirugía Española (English Edition)
• 出版年：2016
• 出版时间：May 2016
• 年：2016
• 卷：94
• 期：5
• 页码：287-293
• 全文大小：470 K

文摘

Circular mucosal anopexy (CMA) achieves a more comfortable postoperative period than resective techniques. But complications and recurrences are not infrequent. This study aims to evaluate of the efficacy of CMA in the treatment of hemorrhoids and rectal mucosal prolapse (RMP).

Method

From 1999 to 2011, 613 patients underwent surgery for either hemorrhoids or RMP in our hospital. CMA was performed in 327 patients. Gender distribution was 196 male and 131 female. Hemorrhoidal grades were distributed as follows: 28 patients had RMP, 46 2nd grade, 146 3rd grade and 107 4th grade. Major ambulatory surgery (MAS) was performed in 79.9%. Recurrence of hemorrhoids was studied and groups of recurrence and no-recurrence were compared. Postoperative pain was evaluated by Visual Analogical Scale (VAS) as well as early complications.

Results

A total of 31 patients needed reoperation (5 RMP, 2 with 2nd grade, 17 with 3rd grade, 7 with 4th grade). No statistically significant differences were found between the non-recurrent group and the recurrent group with regards to gender, surgical time or hemorrhoidal grade, but there were differences related to age. In the VAS, 81.3% of patients expressed a postoperative pain ≤2 at the first week. Five patients needed reoperation for early postoperative bleeding. Six patients needed admission for postoperative pain.

Conclusions

Recurrence rate is higher in CMA than in resective techniques. CMA is a useful technique for the treatment of hemorrhoids in MAS. Pain and the rate of complications are both low.