title: A prospective and comparative study between stapled hemorrhoidopexy and hemorrhoidal artery ligation with mucopexy.
abstract: OBJECTIVE
  The aim of this study was to compare the efficacy between stapled hemorrhoidopexy (Longo technique) and transanal hemorrhoidal artery ligation with mucopexy (THDm) in the treatment of hemorrhoidal disease.
  
  
  METHODS
  From June 2009 to January 2011, 81 patients having grade II or III hemorrhoidal disease underwent prospective evaluation followed by surgery at two centers (27 Longo and 54 THDm). Symptoms (bleeding, tenesmus, prolapse, fecal incontinence, pain) and the satisfaction score were compared on the first post-operative day and at 1, 6, 12, and 24 months thereafter. The follow-up was 24 months.
  
  
  RESULTS
  There was no difference in mean length of stay. One complication (recto-vaginal fistula) was observed after Longo. The prolapse score was significantly lower after THDm than after Longo on the first post-operative day (P < 0.0015). Bleeding score after THDm was significantly lower on the first post-operative day (P = 0.04), but higher thereafter (P = 0.03 and P = 0.04). Tenesmus score after THDm was significantly lower for the first three months (P < 0.06 and 0.001). On the first post-operative day and at one month, the visual analog pain score was significantly lower after THDm than that after Longo (P < 0.0003 et P < 0.01). On the first post-operative day and at one month, the satisfaction score was higher after THDm than after Longo (P < 0.001).
  
  
  CONCLUSIONS
  THDm was safe and effective. Short-term outcomes after THDm were better than after Longo but long-term results seemed to be similar.
authors.affiliation: Service de chirurgie digestive, CHU Carémeau, place du Professeur-Debré, 30029 Nîmes, France.
authors.forename: A
authors.initials: A
authors.lastname: Béliard
authors.affiliation: Service de chirurgie viscérale, CHG de Carcassonne, 11000 Carcassonne, France.
authors.forename: F
authors.initials: F
authors.lastname: Labbé
authors.affiliation: Service d'hépato-gastroentérologie, CHU Carémeau, place du Professeur-Debré, 30029 Nîmes, France.
authors.forename: D
authors.initials: D
authors.lastname: de Faucal
authors.affiliation: Service d'hépato-gastroentérologie, CHU Carémeau, place du Professeur-Debré, 30029 Nîmes, France.
authors.forename: J-M
authors.initials: JM
authors.lastname: Fabreguette
authors.affiliation: Service d'hépato-gastroentérologie, CHU Carémeau, place du Professeur-Debré, 30029 Nîmes, France.
authors.forename: P
authors.initials: P
authors.lastname: Pouderoux
authors.affiliation: Service de chirurgie digestive, CHU Carémeau, place du Professeur-Debré, 30029 Nîmes, France. Electronic address: frederic.borie@chu-nimes.fr.
authors.forename: F
authors.initials: F
authors.lastname: Borie
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001158:Arteries / Q000601:surgery; D016009:Chi-Square Distribution; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D061865:Hemorrhoidectomy / Q000295:instrumentation / Q000379:methods*; D006484:Hemorrhoids / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007413:Intestinal Mucosa / Q000601:surgery*; D007902:Length of Stay; D008026:Ligation / Q000379:methods; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D010149:Postoperative Pain / Q000503:physiopathology; D011446:Prospective Studies; D012007:Rectum / Q000098:blood supply* / Q000601:surgery; D012720:Severity of Illness Index; D017792:Surgical Stapling / Q000379:methods*; D016896:Treatment Outcome; D014463:Ultrasonography; D055815:Young Adult
keywords: Artery ligation; Hemorrhoid; Mucopexy; Stapled hemorrhoidopexy