Annals of Coloproctology

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Anorectal benign disease

A comparative study on efficacy and safety of modified partial stapled hemorrhoidopexy versus conventional hemorrhoidectomy: a prospective randomized controlled trial: Tae Gyu Kim, Chul Seung Lee, Dong Geun Lee, Choon Sik Chung, Seung Han Kim, Sang Hwa Yu, Jeong Eun Lee, Gwan Cheol Lee, Dong Woo Kang, Jeong Sub Kim, Gyu Young Jeong; Ann Coloproctol. 2025;41(2):145-153. Published online April 28, 2025; DOI: https://doi.org/10.3393/ac.2024.00535.0076

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Abstract PDF Supplementary Material: Purpose
The long-term outcomes and efficacy of partial stapled hemorrhoidopexy (PSH) compared with those of conventional hemorrhoidectomy (CH) are not fully understood. This study aimed to introduce a modified PSH (mPSH) and compare its clinical efficacy and safety with those of CH.
Methods
A prospective randomized controlled trial was conducted. This study was performed at a single hospital and involved 6 colorectal surgeons. In total, 110 patients were enrolled between July 2019 and September 2020. Patients were randomly assigned to undergo either mPSH group (n=55) or CH group (n=55). The primary outcome was to compare postoperative average pain and postoperative peak pain using visual analog scale score between the 2 groups.
Results
The required duration of analgesia was shorter in the mPSH group than in the CH group, although the difference was not statistically significant (P=0.096). However, the laxative requirement duration (P<0.010), return to work (P<0.010), satisfaction score (P<0.010), and Vaizey score (P=0.014) were significantly better in the mPSH group. The average and peak postoperative pain scores were significantly lower in the mPSH group during the 15 days after surgery (P<0.001). The overall complication rate in both groups was 9.1%, with no significant difference between the groups (P=0.867).
Conclusion
The mPSH group demonstrated better improvement in symptoms, lower pain scores, and greater patient early satisfaction after surgery than the CH group. Therefore, this surgical technique appears to be a safe and effective alternative for CH.

Comparison of Long-term Clinical Outcomes according to the Change in the Rectocele Depth between Transanal and Transvaginal Repairs for a Symptomatic Rectocele: Choon Sik Chung, Sang Hwa Yu, Jeong Eun Lee, Dong Keun Lee; J Korean Soc Coloproctol. 2012;28(3):140-144. Published online June 30, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.3.140

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13 Citations

Abstract PDF

Purpose

This study was aimed to compare the results of a transanal repair with those of a transvaginal levatorplasty and to determine the long-term clinical outcomes according to the change in the depth of the rectocele after the procedure.

Methods

Of 50 women who underwent a rectocele repair from March 2005 to February 2007, 26 women (group A) received a transanal repair, and 24 (group B) received a transvaginal repair with or without levatorplasty. At 12 months after the procedures, 45 (group A/B, 22/23 women) among the 50 women completed physiologic studies, including anal manometry and defecography, and clinical-outcome measurements. The variations of the clinical outcomes with changes in the depth of the rectocele were also evaluated in 42 women (group A/B, 20/22) at the median follow-up of 50 months.

Results

On the defecographic findings, the postoperative depth of the rectocele decreased significantly in both groups (group A vs. B, 1.91 ± 0.20 vs. 2.25 ± 0.46, P = 0.040). At 12 months after surgery, 17 women in each group (group A/B, 77/75%) reported improvement of their symptoms. However, only 11 and 13 women (group A/B, 55/59%) of groups A and B, respectively, maintained their improvement at the median follow-up of 50 months. Better results were reported in patients with a greater change in the depth of their rectocele (≥4 cm) after the procedure (P = 0.001)

Conclusion

In both procedures, clinical outcomes might become progressively worse as the length of the follow-up is increased.

Citations

Citations to this article as recorded by

Outcomes of laparoscopic ventral mesh rectopexy versus trans-vaginal repair in management of anterior rectocele, a randomized controlled trial
A. Sanad, A. Sakr, H. Elfeki, W. Omar, W. Thabet, E. Fouda, E. Abdallah, S. A. Elbaz
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Arnold Wald, Adil E. Bharucha, Berkeley Limketkai, Allison Malcolm, Jose M. Remes-Troche, William E. Whitehead, Massarat Zutshi
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Early and late effects of the sequential transfixed stich technique for the treatment of the symptomatic rectocele without rectal mucosa prolapse
Fabio Gaj, Ivano Biviano, Antonello Trecca, Quirino Lai, Jacopo Andreuccetti
Minerva Chirurgica.2020;[Epub] CrossRef
Absence of a rectocele may be correlated with reduced internal anal sphincter function in patients with rectal intussusception and fecal incontinence
Akira Tsunoda, Tomoko Takahashi, Hiroshi Kusanagi
International Journal of Colorectal Disease.2019; 34(10): 1681. CrossRef
Trattamento chirurgico del rettocele
G. Meurette, A. Vénara, P.-A. Lehur
EMC - Tecniche Chirurgiche Addominale.2018; 24(1): 1. CrossRef
Tratamiento quirúrgico de los rectoceles
G. Meurette, A. Vénara, P.-A. Lehur
EMC - Técnicas Quirúrgicas - Aparato Digestivo.2018; 34(1): 1. CrossRef
Surgery for constipation: systematic review and practice recommendations
U. Grossi, E. J. Horrocks, J. Mason, C. H. Knowles, A. B. Williams
Colorectal Disease.2017; 19(S3): 73. CrossRef
Traitement chirurgical des rectocèles
G. Meurette, A. Vénara, P.-A. Lehur
EMC - Techniques chirurgicales - Appareil digestif.2017; 34(4): 1. CrossRef

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