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

الملخص EN

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.