TITLE

PPH-01 Versus PPH-03 to Perform STARR for the Treatment of Hemorrhoids Associated With Large Internal Rectal Prolapse: A Prospective Multicenter Randomized Trial

AUTHOR(S)
Renzi, Adolfo; Brillantino, Antonio; Di Sarno, Giandomenico; D’Aniello, Francesco; Giordano, Alfredo; Stefanuto, Alberto; Aguzzi, Daniele; Daffinà, Antonio; Ceci, Francesco; D’Oriano, Giuseppe; Mercuri, Massimo; Alderisio, Alfonso; Perretta, Luis; Carrino, Francesco; Sernia, Giovanni; Greco, Ettore; Picchio, Marcello; Marino, Giuseppe; Goglia, Angelo; Trombetti, Amilcare
PUB. DATE
September 2011
SOURCE
Surgical Innovation;Sep2011, Vol. 18 Issue 3, p241
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Purpose. This multicenter randomized study was designed to compare the clinical and functional results of stapled transanal rectal resection (STARR) performed with 2 staplers (PPH-01 vs. PPH-03) in the treatment of hemorrhoidal disease associated with a large internal rectal prolapse. Methods. From a total of 937 patients, referred for hemorrhoidal disease in the 20 centers involved in the study, 425 (45.3%) with prolapsed hemorrhoids associated with a large internal rectal prolapse were randomized to undergo STARR with PPH-01 or PPH-03. Postoperative evaluation was made at 3, 6, and 12 months. Results. The incidence of bleeding at the stapled line was significantly lower in the PPH-03 group than in the PPH-01 group (58/207 [28.0%] vs. 145/201 [72.1%]; P < .0001); the mean number of hemostatic stitches was significantly higher in the PPH-01 than in the PPH-03 group (3.2 ± 0.1 vs. 1.8 ± 0.8; P < .0001). The mean operative time was 25.1 ± 11.5 minutes in the PPH-03 group and 38.1 ± 15.7 minutes in the PPH-01 group (P < .0001). No major complications occurred in either of the groups. At 12-month follow-up, the success rate in the 2 groups was 94.5% in the PPH01 group and 94.2% in the PPH03 group. Conclusion. STARR performed for the treatment of hemorrhoidal disease associated with a large rectal prolapse is a safe and effective procedure. The use of the PPH-03 stapler instead of the PPH-01 guarantees a statistically significant reduction of intraoperative bleeding and a significant decrease of the operative time.
ACCESSION #
67672676

 

Related Articles

  • Double PPH Technique for Hemorrhoidal Prolapse: A Multicentric, Prospective, and Nonrandomized Trial. Braini, A.; Narisetty, P.; Favero, A.; Calandra, S.; Calandra, A.; Caponnetto, F.; Digito, F.; Da Pozzo, F.; Marcotti, E.; Porebski, E.; Rovedo, S.; Terrosu, G.; Torricelli, L.; Stuto, A. // Surgical Innovation;Dec2013, Vol. 20 Issue 6, p553 

    Introduction. Longo’s technique (or PPH technique) is well known worldwide. Meta-analysis suggests that the failure due to persistence or recurrence is close to 7.7%. One of the reasons for the recurrence is the treatment of the advanced hemorrhoidal prolapse with a single stapling...

  • Agraffectomy after low rectal stapling procedures for hemorrhoids and rectocele. Pescatori, M.; Gagliardi, G. // Techniques in Coloproctology;Sep2011, Vol. 15 Issue 3, p265 

    In this article, the authors discuss the review by S. Petersen, J. Jongen, and W. Schwenk in the 2011 issue. They state that Petersen and colleagues have warned against the complications of retained staples after stapled transanal rectal resection (STARR) and procedure for prolapse and...

  • Retained staples causing rectal bleeding and severe proctalgia after the STARR procedure. Boffi, F. // Techniques in Coloproctology;Jun2008, Vol. 12 Issue 2, p135 

    A letter to the editor is presented in response to the article "Postoperative Complications After Procedure for Prolapsed Hemorrhoids (PPH) and Stapled Transanal Rectal Resection (STARR) Procedures" by M. Pescatori et al.

  • Prospective Randomized Clinical Trial Comparing Two Different Circular Staplers for Mucosectomy in the Treatment of Hemorrhoids. Arroyo, Antonio; Pérez-Vicente, Francisco; Miranda, Elena; Sánchez, Ana; Serrano, Pilar; Candela, Fernando; Oliver, Israel; Calpena, Rafael // World Journal of Surgery;Jul2006, Vol. 30 Issue 7, p1305 

    Background: The main objections against circular stapled mucosectomy have been anal pain and rectal bleeding during the surgical procedure or in the immediate postoperative follow-up. To avoid these consequences, a new stapler (PPH33-03) has been developed. The aim of this trial was to compare...

  • Rectal pocket syndrome following PPH and rectosigmoid resection. Pescatori, M. // Techniques in Coloproctology;Sep2011, Vol. 15 Issue 3, p363 

    The article discusses the case of a 55-year-old woman who underwent another procedure for prolapse and hemorrhoids (PPH) after she continued suffering from mucosal prolapse and obstructed defecation two years following the first PPH for rectocele and rectal internal mucosal prolapse.

  • Procedure for Prolapsed Hemorrhoids for Treatment of Rectal Mucosa Prolapse Following Anorectoplasty for Imperforate Anus. Amortegui, Jose D.; Solla, Julio A. // American Surgeon;May2008, Vol. 74 Issue 5, p443 

    Surgical management of imperforate anus and rectal mucosal prolapse has evolved significantly over the last two decades. The procedure for prolapsed hemorrhoids (PPH) is now widely used primarily for rectal mucosal prolapse and internal hemorrhoids. We describe the use of PPH in the management...

  • Estudio comparativo: Procedimiento de desarterialización transanal de hemorroides vs. procedimiento para prolapso y hemorroides para el tratamiento de enfermedad hemorroidal grado III. Pérez-Aguirre, Javier; Guerrero-Guerrero, Víctor Hugo; García-Jonguitud, Salvador // Revista de Sanidad Militar;sep/oct2013, Vol. 67 Issue 5, p184 

    Introduction. The hemorrhoidal disease is a common disease in Mexico, 5% of the population experiences symptoms related to it, it is known that 12.9 million people affected annually. Treatment includes dietary hygienic measures, drugs and in patients with grade IV condition, specific procedures...

  • Is there a post-PPH syndrome? Khubchandani, I.; Fealk, M. H.; Reed III, J. F. // Techniques in Coloproctology;Jun2009, Vol. 13 Issue 2, p141 

    Despite early studies reporting significant decreases in postoperative pain and morbidity with the procedure for prolapse and hemorrhoids (PPH) compared to traditional hemorrhoidectomy, certain complications and long-term efficacy remain uncertain. This study was performed to assess the...

  • Life threatening rectal perforation after procedures for prolapse and hemorrhoids (PPH). Xue, Qi-Ming; He, Hong-Bo; Wu, Jing; Li, Ning // International Journal of Colorectal Disease;Jul2012, Vol. 27 Issue 7, p993 

    A letter to the editor is presented which discusses the life threatening rectal perforation in prolapsed and hemorrhoids (PPH) patients after undergoing hemorrhoidectomy procedures.

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics