Page 37 - World Journal of Laparoscopic Surgery

Hemorrhoidectomy by MIPH
is significant innovation in the treatment of hemorrhoids. Instead of 2. Au-Yong I, Rowsell M, Hemingway DM. Randomised controlled
removing columns of hemorrhoidal tissue, this operation removes clinical trial of stapled haemorrhoidectomy vs conventional
a sleeve of distal-most rectal mucosa and submucosa, elevating haemorrhoidectomy; a three and a half year follow-up. Colorectal
the anal canal and fixing it in place (hence anopexy) and radically Dis 2004;6(1):37–38. DOI: 10.1111/j.1463-1318.2004.00496.x.
reducing the redundancy of mucosa. 10,11 3. Bikhchandani J, Agarwal PN, Kant R, et al. Randomized controlled trial
to compare the early and mid-term results of stapled versus open
Several randomized controlled trials described the safety hemorrhoidectomy. Am J Surg 2005;189(1):56–60. DOI: 10.1016/j.
and effectiveness of MIPH. Systematic reviews of randomized amjsurg.2004.03.014.
controlled trials followed by meta-analyses have demonstrated 4. Boccasanta P, Capretti PG, Vebturi M, et al. Randomised controlled trial
that the short-term outcomes result in favor of MIPH when between stapled circumferential mucosectomy and conventional
12
compared with traditional excisional techniques. Chiefly, MIPH circular hemorrhoidectomy in advanced hemorrhoids with external
has several advantages over conventional hemorrhoidectomy, mucosal prolapse. Am J Surg 2001;182(1):64–68. DOI: 10.1016/s0002-
such as minimal pain with minimal blood loss, minimal operative 9610(01)00654-7.
time, quick recovery, and reduced hospital stay. However, meta- 5. Burch J, Epstein D, Baba-Akbari A, et al. Stapled haemorrhoidectomy
analyses of randomized controlled trials have described that MIPH (haemorrhoidopexy) for the treatment of haemorrhoids: A systematic
review and economic evaluation. Health Technol Assess 2008;12(8):
has a higher recurrence rate than conventional hemorrhoidectomy. 1–193. DOI: 10.3310/hta12080.
Minimal invasive procedure for hemorrhoids appears to be an easy 6. Burch J, Epstein D, Sari AB, et al. Stapled haemorrhoidopexy for the
and rapid operation rather than other transanal dearterialization treatment of haemorrhoids: A systematic review. Colorectal Dis
procedures. But during the procedure, technical errors have a vital 2009;11(3):233–243. DOI: 10.1111/j.1463-1318.2008.01638.x.
role in the recurrence rate when compared with conventional 7. Cheetham MJ, Cohen CR, Kamm MA, et al. A randomized, controlled
hemorrhoidectomy. Estimating of removal of the amount of trial of diathermy hemorrhoidectomy vs. stapled hemorrhoidectomy
prolapsed mucosa is a major practical drawback of the procedure in an intended day-care setting with longer-term follow-up. Dis Colon
Rectum 2003;46(4): 491–497. DOI: 10.1007/s10350-004-6588-z.
of MIPH. But, however, the simple logic is to resect a larger amount 8. Johanson JF, Sonnenberg A. The prevalence of hemorrhoids and
of rectal mucosa in a higher degree of hemorrhoid prolapse. chronic constipation. An epidemiologic study. Gastroenterology
1990;98(2):380–386. DOI: 10.1016/0016-5085(90)90828-o.
conclusIon 9. Ganz RA. The evaluation and treatment of hemorrhoids: A guide
for the gastroenterologist. Clin Gastroenterol Hepatol 2013;11(6):
Stapled hemorrhoidopexy represents a relatively easy and rapid 593–603. DOI: 10.1016/j.cgh.2012.12.020.
operation with less blood loss during surgery, especially when 10. Ali Algadiem E, Aleisa AA, Alsubaie HI, et al. Blood loss estimation
compared with other traditional procedures. The cost of MIPH gun using gauze visual analogue. Trauma Mon 2016;21 (2):e34131. DOI:
was the only major limitation. However, due to existing evidence 10.5812/traumamon-34131.
during the procedure, technical errors have a vital role in recurrence 11. Longo A. Treatment of hemorrhoids disease by reduction of mucosa
rate when compared with conventional hemorrhoidectomy. and hemorrhoidal prolapse with a circular suturing device: A new
Inspite of this controversy, SH is being used successfully in the procedure. Proceedings of the 6th World Congress of Endoscopic
surgery. Monduzzi Publishing Bologna, Rome, Italy; 1998: pp. 777–784.
management of hemorrhoids. 12. Mehigan BJ, Monson JR, Hartley JE. Stapling procedure for
hemorrhoids versus Milligane Morgan. Hemorrhoidectomy:
references Randomized controlled trial. Lancet 2000;355(9206):782–785. DOI:
1. Araujo SEA, Horcel L de A, Seid VE, et al. Resultados tardios após 10.1016/S0140-6736(99)08362-2.
hemorroidopexia mecânica isolada e complementada por operação
excisional. Arq Bras Cir Dig 2016;29(3):159–163. DOI: 10.1590/0102-
6720201600030008.

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