Stapled Haemorrhoidopexy in Germany
In Germany stapled haemorrhoidopexy (SH) was introduced in 1998. Compared to the traditional procedures like excisional haemorrhoidectomy (EH) or anoplasty, SH had several advantages: less blood loss, shorter operation time, less pain, less time off work, etc. These advantages and the introduction o...
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| Main Authors: | , , , |
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| Format: | Article |
| Language: | zho |
| Published: |
Editorial Office of Journal of Colorectal & Anal Surgery
2023-06-01
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| Series: | 结直肠肛门外科 |
| Subjects: | |
| Online Access: | https://jcas.gxmuyfy.cn/cn/wqll/paper.html?id=221&cateName=2023%E5%B9%B4%20%E7%AC%AC29%E5%8D%B7%20%E7%AC%AC3%E6%9C%9F |
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| Summary: | In Germany stapled haemorrhoidopexy (SH) was introduced in 1998. Compared to the traditional procedures like excisional haemorrhoidectomy (EH) or anoplasty, SH had several advantages: less blood loss, shorter operation time, less pain, less time off work, etc. These advantages and the introduction of Procedure for Prolapse and Haemorrhoids (PPH) with its standardized procedural steps led to a rapid acceptance leading to a nationwide spread of the procedure. Because it was a completely new procedure for surgeons, there was a learning curve to be taken. In the beginning the stapling device was used in haemorrhoids ranging from 2nd to 4th degree. At the end of 1999, however, it was known that 4th degree haemorrhoids were not suitable for SH, because of a high rate of recurrent prolapse. Most patients were pain free after a couple of days and went back to work again accordingly, however a small number of patients had severe pain after SH, some of them for a long period of time. Surgeons were confronted with severe complications that were usually not encountered after traditional haemorrhoidal surgery. This led to a re-appraisal of the SH procedure, especially after the introduction of energy-driven devices for EH. In addition, a randomised controlled trial showed that the advantage of SH (less pain and shorter period off-work) compared to EH declined during follow up and the costs of SH were higher than that of EH. Today SH still has its place in surgery of haemorrhoidal disease (HD), but the indication for the procedure has been limited and should be critically discussed with the patient. In this respect, it is not surprising that the procedure is not performed as often as 20 years ago. |
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| ISSN: | 1674-0491 |