Evolution of the transfixed stitches technique hemorrhoidectomy.
OBJECTIVE
To date, the types of surgical hemorrhoidal treatments available for a surgeon are manifold. The authors, beginning from an original interpretation of the indications for a surgical treatment of hemorrhoids, based on the new disease classification defined PATE 2006, hereby present the results related to the evolution in performing hemorrhoidectomy with the transfixed stitches technique (TPT).


METHODS
A total of 50 patients, 30 males and 20 females, with diagnosis of hemorrhoids of grade III-IV underwent hemorrhoidectomy with the TPT, which consisted in using two suture threads (Monofil) for each nodule. Patients' follow-up was prolonged for six months after the surgical intervention.


RESULTS
The mean score, according to the PATE 2006 classification, after the intervention was significantly lower in all patients in comparison to the initial mean score (23.7 versus 7.2, P<0.01). The mean score value of the early stage complications was 4.8 while that of the late stage complications was 2.2. We found a reduction in the score related to the recorded pain after 24 and 96 hours from the intervention (3 versus 1.4, P=0.05). Only 26% of the patients who underwent hemorrhoidectomy with the new TPT were administered non-steroidal anti-inflammatory drugs. The relapse rate was only of 2%.


CONCLUSIONS
The TPT, performed with the new technique, allows to reach best results in comparison to the previous surgical options, by reducing the incidence of disease relapse and the infectious events during the postoperative period, thus reducing the needed time for return to working activity.
Department of General Surgery and Organ Transplantation, Paride Stefanini Institute, University of Rome La Sapienza, Rome, Italy. fagaj@tin.it
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D000293:Adolescent; D000328:Adult; D000368:Aged; D013505:Digestive System Surgical Procedures / Q000379:methods; D005260:Female; D006484:Hemorrhoids / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055502:Secondary Prevention; D017792:Surgical Stapling / Q000009:adverse effects / Q000379:methods*; D013536:Suture Techniques; D016896:Treatment Outcome