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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


Affiliations
1 ColoproctologyUnit, Casa di Cura San Camillo-Forte deiMarmi, Lucca, Italy
2 General Surgery and Breast Unit, IRCCS "San Martino-IST", Genoa, Italy
3 Medical Oncology, IRCCS "San Martino-IST", Genoa, Italy
4 General Surgery, Casa di Cura Triolo-Zancla e Villa Serena, Palermo, Italy
5 Coloproctology Unit, San Camillo Hospital, Rome, Italy
6 General Surgery, Villa Paideia Hospital, Rome, Italy
7 General Surgery, Celio Military Hospital, Rome, Italy
8 General Surgery, Policlinico Umberto I, Rome, India
9 General Surgery, San Carlo IDI Hospital, Rome, Italy
10 General Surgery, Fatebenefratelli Hospital, Rome, Italy
 

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 12months 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/12mo 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.
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  • 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

Abstract Views: 61  |  PDF Views: 0

Authors

Giuliano Reboa
ColoproctologyUnit, Casa di Cura San Camillo-Forte deiMarmi, Lucca, Italy
Marco Gipponi
General Surgery and Breast Unit, IRCCS "San Martino-IST", Genoa, Italy
Maurizio Gallo
Medical Oncology, IRCCS "San Martino-IST", Genoa, Italy
Giovanni Ciotta
General Surgery, Casa di Cura Triolo-Zancla e Villa Serena, Palermo, Italy
Marco Tarantello
General Surgery, Casa di Cura Triolo-Zancla e Villa Serena, Palermo, Italy
Angelo Caviglia
Coloproctology Unit, San Camillo Hospital, Rome, Italy
Antonio Pagliazzo
ColoproctologyUnit, Casa di Cura San Camillo-Forte deiMarmi, Lucca, Italy
Luigi Masoni
General Surgery, Villa Paideia Hospital, Rome, Italy
Giuseppe Caldarelli
General Surgery, Celio Military Hospital, Rome, Italy
Fabio Gaj
General Surgery, Policlinico Umberto I, Rome, India
Bruno Masci
General Surgery, San Carlo IDI Hospital, Rome, Italy
Andrea Verdi
General Surgery, Fatebenefratelli Hospital, Rome, Italy

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 12months 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/12mo 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.