title: [Should surgical thread influence the outcome of haemorrhoidectomy with the transfixed stitch technique?].
abstract: The technique of haemorrhoidectomy with the transfixed stitch technique (TST) is a surgical treatment modality for haemorrhoids that is available to the surgeon. The authors, through a personal interpretation of haemorrhoids based on the PATE 2006 classification, report the results of a comparative trial, using TST with two different surgical threads, Assufil and Monofil. The aim of this prospective randomised trial was to compare the results with the use of each surgical thread, analysing early postoperative side effects (bleeding, urinary retention, pain), late postoperative side effects (pain, bleeding, stricture, anal secretion, tenesmus and faecal incontinence), return to active life and quality of life. Patients with grade III-IV haemorrhoids were enrolled in our study and divided into two groups, one treated with TST using Assufil and the other treated with TST using Monofil. The main outcome measures such as analgesic intake during the first week, early and late side effects, return to active life and quality of life were evaluated. Patients were followed for six months after surgery. A total of 40 patients were enrolled, 20 per group. The pain score after surgery was significantly lower in all patients treated with TST. Thirty percent of TST patients treated with Monofil took analgesics in comparison to 35% of the Assufil group (p = ns). Postoperative pain after the start of bowel movements in TST patients was similar in the two groups. TST patients treated with Monofil showed a low incidence of discomfort and surgical oedema in comparison to the Assufil group. Side effects, surgical time and return to active life in patients treated with TST were similar in the two groups. TST haemorrhoidectomy is more advantageous utilising Monofil surgical thread because of its lower complication rate.
authors.affiliation: Dipartimento di Chirurgia Generale e Trapianti d'Organo, Istituto Paride Stefanini, Università degli Studi La Sapienza, Roma.
authors.forename: Fabio
authors.initials: F
authors.lastname: Gaj
authors.forename: Antonello
authors.initials: A
authors.lastname: Trecca
authors.forename: Pietro
authors.initials: P
authors.lastname: Crispino
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006484:Hemorrhoids / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013536:Suture Techniques; D016896:Treatment Outcome