Predictors of recurrence of prolapse after procedure for prolapse and haemorrhoids

Aim  The procedure for prolapse and haemorrhoids (PPH) is an effective surgical therapy for symptomatic haemorrhoids. Compared with haemorrhoidectomy, meta‐analysis has shown PPH to be less painful, with higher patient satisfaction and a quicker return to work, but at the cost of higher prolapse rec...

Full description

Saved in:
Bibliographic Details
Published in:Colorectal disease 2012-08, Vol.14 (8), p.989-996
Main Authors: Festen, S., Molthof, H., van Geloven, A. A. W., Luchters, S., Gerhards, M. F.
Format: Article
Language:English
Subjects:
Female
haemorrhoidopexy
Haemorrhoids
Hemorrhoidectomy - methods
Hemorrhoids - physiopathology
Hemorrhoids - surgery
Humans
Male
Middle Aged
Multivariate Analysis
Patient Satisfaction
PPH
Predictive Value of Tests
Rectal Prolapse - physiopathology
Rectal Prolapse - surgery
Recurrence
Retrospective Studies
stapled anopexy
Treatment Outcome
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Aim  The procedure for prolapse and haemorrhoids (PPH) is an effective surgical therapy for symptomatic haemorrhoids. Compared with haemorrhoidectomy, meta‐analysis has shown PPH to be less painful, with higher patient satisfaction and a quicker return to work, but at the cost of higher prolapse recurrence rates. This is the first report describing predictors of prolapse recurrence after PPH. Method  A cohort of patients with symptomatic haemorrhoids, treated with PPH in our hospital between 2002 and 2009, was retrospectively analysed. Multivariate analysis was performed to identify patient‐related and perioperative predictors associated with persisting prolapse and prolapse recurrence. Results  In total, 159 consecutively enrolled patients were analysed. Persistence and recurrence of prolapse was observed in 16% of the patients. Increased surgical experience showed a trend towards lower recurrence rates. Multivariate analysis identified female gender, long duration of PPH surgery and the absence of muscle tissue in the resected specimen as independent predictors of postoperative persistence of prolapse of haemorrhoids. The absence of prior treatment with rubber band ligation (RBL) as well as increased PPH experience at the hospital showed a trend towards a higher rate of prolapse recurrence. Conclusion  In order to reduce recurrence of prolapse, PPH should be performed by a surgeon with adequate PPH experience, patients should be treated with RBL prior to PPH and a resection of mucosa with underlying muscle fibres should be strived for.
ISSN:1462-8910
1463-1318
DOI:10.1111/j.1463-1318.2011.02837.x