title: 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: 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 12 months 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/12 mo 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.
authors.affiliation: Coloproctology Unit, Casa di Cura San Camillo-Forte dei Marmi, Lucca, Italy.
authors.forename: Giuliano
authors.initials: G
authors.lastname: Reboa
authors.affiliation: General Surgery and Breast Unit, IRCCS "San Martino-IST", Genoa, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Gipponi
authors.affiliation: Medical Oncology, IRCCS "San Martino-IST", Genoa, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Gallo
authors.affiliation: General Surgery, Casa di Cura Triolo-Zancla e Villa Serena, Palermo, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Ciotta
authors.affiliation: General Surgery, Casa di Cura Triolo-Zancla e Villa Serena, Palermo, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Tarantello
authors.affiliation: Coloproctology Unit, San Camillo Hospital, Rome, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Caviglia
authors.affiliation: Coloproctology Unit, Casa di Cura San Camillo-Forte dei Marmi, Lucca, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Pagliazzo
authors.affiliation: General Surgery, Villa Paideia Hospital, Rome, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Masoni
authors.affiliation: General Surgery, Celio Military Hospital, Rome, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Caldarelli
authors.affiliation: General Surgery, Policlinico Umberto I, Rome, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Gaj
authors.affiliation: General Surgery, San Carlo IDI Hospital, Rome, Italy.
authors.forename: Bruno
authors.initials: B
authors.lastname: Masci
authors.affiliation: General Surgery, Fatebenefratelli Hospital, Rome, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Verdi