Tags

Type your tag names separated by a space and hit enter

One-year outcome of haemorrhoidectomy: a prospective multicentre French study.
Colorectal Dis. 2013 Jun; 15(6):719-26.CD

Abstract

AIM

An evaluation was performed of the 1-year outcome of open haemorrhoidectomy (Milligan and Morgan alone or with posterior mucosal anoplasty [the Leopold Bellan procedure]).

METHOD

A prospective, multicentre, observational study included all patients having a planned haemorrhoidectomy from January 2007 to June 2008. Data were collected before surgery, and at 3 months and 1 year after surgery. Patients assessed their anal symptoms and quality of life (SF-36).

RESULTS

Six-hundred and thirty-three patients (median age = 48 years, 56.5% women) underwent haemorrhoidectomy either by the Milligan and Morgan procedure alone (n = 231, 36.5%) or together with the Leopold Bellan procedure (posterior mucosal anoplasty) for resection of a fourth haemorrhoid (n = 345, 54.5%), anal fissure (n = 56, 8.9%) or low anal fistula (n = 1, 0.16%). The median healing time was 6 weeks. Early complications included urinary retention (n = 3), bleeding (n = 11), local infection (n = 7) and faecal impaction (n = 9). At 1 year, the main complications included skin tags (n = 2) and anal stenosis (n = 23). There were three recurrences requiring a second haemorrhoidectomy. On a visual analogue scale, anal pain at 1 year had fallen from a median of 5.5/10 before treatment to 0.1/10 (p < 0.001), anal discomfort from 5.5/10 to 0.1/10 (P < 0.001) and the Knowles-Eckersley-Scott Symptom (KESS) constipation score from 9/45 to 6/45 (P < 0.001). The median Wexner score for anal incontinence was unchanged (2/20). De-novo anal incontinence (a Wexner score of >5) affected 8.5% of patients at 1 year, but preoperative incontinence disappeared in 16.7% of patients with this symptom. All physical and mental domains of quality of life significantly improved, and 88% of patients were satisfied or very satisfied.

CONCLUSION

Complications of open haemorrhoidectomy were infrequent. Anal continence was not altered. Comfort and well-being were significantly improved at 1 year after surgery. Patient satisfaction was high despite residual anal symptoms.

Authors+Show Affiliations

Service de Proctologie, Hôpital Bagatelle, Talence, France. proctobouc@gmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Observational Study

Language

eng

PubMed ID

23216822

Citation

Bouchard, D, et al. "One-year Outcome of Haemorrhoidectomy: a Prospective Multicentre French Study." Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland, vol. 15, no. 6, 2013, pp. 719-26.
Bouchard D, Abramowitz L, Castinel A, et al. One-year outcome of haemorrhoidectomy: a prospective multicentre French study. Colorectal Dis. 2013;15(6):719-26.
Bouchard, D., Abramowitz, L., Castinel, A., Suduca, J. M., Staumont, G., Soudan, D., Devulder, F., Pigot, F., Varastet, M., & Ganansia, R. (2013). One-year outcome of haemorrhoidectomy: a prospective multicentre French study. Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland, 15(6), 719-26. https://doi.org/10.1111/codi.12090
Bouchard D, et al. One-year Outcome of Haemorrhoidectomy: a Prospective Multicentre French Study. Colorectal Dis. 2013;15(6):719-26. PubMed PMID: 23216822.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - One-year outcome of haemorrhoidectomy: a prospective multicentre French study. AU - Bouchard,D, AU - Abramowitz,L, AU - Castinel,A, AU - Suduca,J M, AU - Staumont,G, AU - Soudan,D, AU - Devulder,F, AU - Pigot,F, AU - Varastet,M, AU - Ganansia,R, AU - ,, AU - ,, PY - 2012/06/14/received PY - 2012/09/14/accepted PY - 2012/12/11/entrez PY - 2012/12/12/pubmed PY - 2014/2/12/medline SP - 719 EP - 26 JF - Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland JO - Colorectal Dis VL - 15 IS - 6 N2 - AIM: An evaluation was performed of the 1-year outcome of open haemorrhoidectomy (Milligan and Morgan alone or with posterior mucosal anoplasty [the Leopold Bellan procedure]). METHOD: A prospective, multicentre, observational study included all patients having a planned haemorrhoidectomy from January 2007 to June 2008. Data were collected before surgery, and at 3 months and 1 year after surgery. Patients assessed their anal symptoms and quality of life (SF-36). RESULTS: Six-hundred and thirty-three patients (median age = 48 years, 56.5% women) underwent haemorrhoidectomy either by the Milligan and Morgan procedure alone (n = 231, 36.5%) or together with the Leopold Bellan procedure (posterior mucosal anoplasty) for resection of a fourth haemorrhoid (n = 345, 54.5%), anal fissure (n = 56, 8.9%) or low anal fistula (n = 1, 0.16%). The median healing time was 6 weeks. Early complications included urinary retention (n = 3), bleeding (n = 11), local infection (n = 7) and faecal impaction (n = 9). At 1 year, the main complications included skin tags (n = 2) and anal stenosis (n = 23). There were three recurrences requiring a second haemorrhoidectomy. On a visual analogue scale, anal pain at 1 year had fallen from a median of 5.5/10 before treatment to 0.1/10 (p < 0.001), anal discomfort from 5.5/10 to 0.1/10 (P < 0.001) and the Knowles-Eckersley-Scott Symptom (KESS) constipation score from 9/45 to 6/45 (P < 0.001). The median Wexner score for anal incontinence was unchanged (2/20). De-novo anal incontinence (a Wexner score of >5) affected 8.5% of patients at 1 year, but preoperative incontinence disappeared in 16.7% of patients with this symptom. All physical and mental domains of quality of life significantly improved, and 88% of patients were satisfied or very satisfied. CONCLUSION: Complications of open haemorrhoidectomy were infrequent. Anal continence was not altered. Comfort and well-being were significantly improved at 1 year after surgery. Patient satisfaction was high despite residual anal symptoms. SN - 1463-1318 UR - https://www.unboundmedicine.com/medline/citation/23216822/One_year_outcome_of_haemorrhoidectomy:_a_prospective_multicentre_French_study_ L2 - https://doi.org/10.1111/codi.12090 DB - PRIME DP - Unbound Medicine ER -