High-Volume Transanal Surgery with CPH34 HV for the Treatment of III-IV Degree Haemorrhoids: Final Short-Term Results of an Italian Multicenter Clinical Study. (21st February 2016)

• Record Type: Journal Article
• Authors: Reboa, Giuliano; Gipponi, Marco; Gallo, Maurizio; Ciotta, Giovanni; Tarantello, Marco; Caviglia, Angelo; Pagliazzo, Antonio; Masoni, Luigi; Caldarelli, Giuseppe; Gaj, Fabio; Masci, Bruno; Verdi, Andrea
• Other Names: Manousos-Georgios Pramateftakis Academic Editor.
• Is Part Of: Surgery research and practice. Volume 2016(2016)
• Publication Date: 2016-02-21
• Subjects: Surgery -- Periodicals; 617.005
• DOI: 10.1155/2016/2906145
• Languages: English
• ISSNs: 2356-7759

Abstract

Abstract : The clinical chart of 621 patients with III-IV haemorrhoids undergoing Stapled Hemorrhoidopexy (SH) with CPH34 HV in 2012–2014 was consecutively reviewed to assess its safety and efficacy after at least 12 months of follow-up. Mean volume of prolapsectomy was significantly higher (13.0 mL; SD, 1.4) in larger prolapse (9.3 mL; SD, 1.2) (p < 0.001 ). Residual or recurrent haemorrhoids occurred in 11 of 621 patients (1.8%) and in 12 of 581 patients (1.9%), respectively. Relapse was correlated with higher preoperative Constipation Scoring System (CSS) (p = 0.000 ), Pescatori 's degree (p = 0.000 ), Goligher 's grade (p = 0.003 ), prolapse exceeding half of the length of the Circular Anal Dilator (CAD) (p = 0.000 ), and higher volume of prolapsectomy (p = 0.000 ). At regression analysis, only the preoperative CSS, Pescatori 's degree, Goligher 's grade, and volume of resection were significantly predictive of relapse. A high level of satisfaction (VAS = 8.6; SD, 1.0) coupled with a reduction of 12-month CSS (Δ preoperative CSS/12 mo CSS = 3.4, SD, 2.0;p < 0.001 ) was observed. The wider prolapsectomy achievable with CPH34 HV determined an overall 3.7% relapse rate in patients with high prevalence of large internal rectal prolapse, coupled with high satisfaction index, significant reduction of CSS, and very low complication rates.