Annals of Coloproctology

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Anorectal benign disease

The importance of compression time in stapled hemorrhoidopexy: is patience a virtue?: Byung Eun Yoo, Wook Ho Kang, Yong Teak Ko, Young Chan Lee, Cheong Ho Lim; Ann Coloproctol. 2024;40(2):176-181. Published online December 20, 2022; DOI: https://doi.org/10.3393/ac.2022.00556.0079

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Purpose
The aim of this study was to evaluate whether longer compression time before firing the stapler reduced the postoperative complications related to staple line formation in stapled hemorrhoidopexy.
Methods
This retrospective case-control study was conducted at a colorectal-anal specialty hospital. Consecutive patients with grades III and IV hemorrhoids who underwent stapled hemorrhoidopexy between January 2016 and November 2019 were included. According to the compression time, patients were assigned to the long compression time group (2 minutes) or the typical compression time group (30 seconds). The primary outcome measure was incidence of staple line complications such as dehiscence, bleeding, and stenosis.
Results
A total of 348 patients treated with stapled hemorrhoidopexy were evaluated. Seventy-three and 275 patients were included in the long compression time group and the typical compression time group, respectively. No significant differences were observed in patient characteristics between the groups. However, additional procedures were performed more frequently in the typical compression time group (78.1% vs. 92.0%, P=0.001). Bleeding occurred more frequently in the typical compression time group (1.4% vs. 8.4%, P=0.030). The rates of dehiscence and stenosis were not significantly different between the groups. Fecal urgency developed more frequently in the typical compression time group (0% vs. 5.1%, P=0.040). In logistic regression analysis, typical compression time (30 seconds) was the only risk factor for bleeding (odds ratio, 8.496; P=0.040).
Conclusion
Longer compression time was associated with a decreased incidence of postoperative bleeding after stapled hemorrhoidopexy.

Citations

Citations to this article as recorded by

Latest Research Trends on the Management of Hemorrhoids
Sung Il Kang
Journal of the Anus, Rectum and Colon.2025; 9(2): 179. CrossRef

The Use of a Staged Drainage Seton for the Treatment of Anal Fistulae or Fistulous Abscesses: Cheong Ho Lim, Hyeon Keun Shin, Wook Ho Kang, Chan Ho Park, Sa Min Hong, Seung Kyu Jeong, June Young Kim, Hyung Kyu Yang; J Korean Soc Coloproctol. 2012;28(6):309-314. Published online December 31, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.6.309

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Abstract PDF

Purpose

The aim of this retrospective study was to evaluate the rate of recurrence and incontinence after the treatment of fistulae or fistulous abscesses by using the staged drainage seton method.

Methods

According to the condition, a drainage seton alone or a drainage seton combined with internal opening (IO) closure and relocation of the seton was used. After a period of time, the seton was changed with 3-0 nylon; then, after another period of time, the authors terminated the treatment by removing the 3-0 nylon. Telephone interviews were used for follow-up. The following were evaluated: the relationship between the type of fistula and recurrence; the relationship between the type of fistula and the period of treatment; the relationship between the recurrence and presence of abscess; the relationship between IO closure and recurrence; the relationship between the period of seton change and recurrence; reported continence for flatus, liquid stool, and solid stool.

Results

The recurrence rate of fistulae or suppuration was 6.5%, but for cases of horseshoe extension, the recurrence rate was 57.1%. The rate of recurrence was related to the type of fistula (P = 0.001). Incontinence developed in 3.8% of the cases. No statistically significant relationship was found between the rate of recurrence and the presence of an abscess or between the closure of the IO and the period of seton change or removal.

Conclusion

In the treatment of anal fistulae or fistulous abscesses, the use of a staged drainage seton can reduce the rate of recurrence and incontinence.

Citations

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Efficacy and safety of video-assisted anal fistula treatment in anorectal fistula: a meta-analysis
Chunqiang WANG, Tianye HUANG, Xuebing WANG
Minerva Gastroenterology.2024;[Epub] CrossRef
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A. G. Khitaryan, A. Z. Alibekov, A. A. Golovina, S. A. Adizov, X. S. Oplimakh
Koloproktologia.2024; 23(4): 94. CrossRef
A Large Study on Lifestyle Factors Increasing Probability of Fistula and Factors Responsible for Recurrent Fistula
Hitender Suri, Deepika Suri, Kamalpreet Bansal, Sauvik Suri, Virendera Ghodke
International Journal of Medical and Oral Research.2022; 7(1): 4. CrossRef
Fistula in Ano: Evolution of Treatment and Present Scenario
Nisar A. Chowdri
Indian Journal of Colo-Rectal Surgery.2022; 5(3): 37. CrossRef
Ambulatory seton placement followed by fistulotomy: efficacy and safety for perianal fistula treatment
Verónica Gamelas, Guilherme Simões, Sara Santos, Rafaela Loureiro, Isabel Seves, João Costa Simões, Maria João Bettencourt
European Journal of Gastroenterology & Hepatology.2021; 33(7): 956. CrossRef
Influence of the cotton and silastic seton on the distance of the anal sphincter cables after fistulotomy in rats
Ana Laura Sanches Lima, Beatriz Schorro Gianini, Bruna Miranda Santana, Carlos Henrique Marques dos Santos, Doroty Mesquita Dourado, Juliano Seger Falcão, Lucas Bannwart, Sara Jéssica Falcão Câmara
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Marie S. De Robles, Robert D. R. Winn
ANZ Journal of Surgery.2020; 90(9): 1764. CrossRef
Relocation and silastic tension only (RASTO) procedure for very long anal fistula tracts: Initial case series with results of a new surgical technique
John Alfred Carr
International Journal of Surgery Open.2020; 26: 1. CrossRef
Comparison of the Efficacy of the Various Treatment Modalities in the Management of Perianal Crohn’s Fistula: A Review
Shah Huzaifa Feroz, Asma Ahmed, Abilash Muralidharan, Pragatheeshwar Thirunavukarasu
Cureus.2020;[Epub] CrossRef
Nigam′s Modified Roeder′s Knot in Cutting Seton in High Fistula-in-ano Prevents Rethreading and Reapplication of Seton
VK Nigam, Siddharth Nigam
World Journal of Colorectal Surgery.2020; 9(4): 64. CrossRef
Loose Seton Technique as a Conventional Procedure for the Treatment of Anal Fistula and Long-Term Results
Hasan Calis
Acta Medica Alanya.2019; 3(1): 67. CrossRef
Ligature method for the treatment of anal fistula: a modern view on the old approach (literature review)
A. I. Musin, E. V. Antipova, A. A. Ulyanov, D. E. Kuznetsov
Grekov's Bulletin of Surgery.2019; 178(2): 79. CrossRef
Drainage Seton Versus External Anal Sphincter–Sparing Seton After Rerouting of the Fistula Tract in the Treatment of Complex Anal Fistula: A Randomized Controlled Trial
Waleed Omar, Abdallah Alqasaby, Mahmoud Abdelnaby, Mohamed Youssef, Mostafa Shalaby, Mohamed Anwar Abdel-Razik, Sameh Hany Emile
Diseases of the Colon & Rectum.2019; 62(8): 980. CrossRef
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Yasmine Hubbard, Denise Rizzolo
JAAPA.2019; 32(1): 1. CrossRef
Draining Setons as Definitive Management of Fistula-in-Ano
Oluwatomilayo O. Daodu, Julia O’Keefe, John A. Heine
Diseases of the Colon & Rectum.2018; 61(4): 499. CrossRef
Gender-based analysis of the characteristics and outcomes of surgery for anal fistula: analysis of more than 560 cases
Sameh Hany Emile, Hesham Elgendy, Ahmad Sakr, Mohamed Youssef, Waleed Thabet, Waleed Omar, Wael Khafagy, Mohamed Farid
Journal of Coloproctology.2018; 38(03): 199. CrossRef
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G. Williams, A. Williams, P. Tozer, R. Phillips, A. Ahmad, D. Jayne, C. Maxwell‐Armstrong
Colorectal Disease.2018; 20(S3): 5. CrossRef
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A. I. Musin, I. V. Kostarev
Khirurgiya. Zhurnal im. N.I. Pirogova.2018; (8): 65. CrossRef
High ligation of the anal fistula tract by lateral approach: A prospective cohort study on a modification of the ligation of the intersphincteric fistula tract (LIFT) technique
Wook Ho Kang, Hyung Kyu Yang, Han Jeong Chang, Yong Taek Ko, Byung Eun Yoo, Cheong Ho Lim, Jae Kwan Hwang, Young Chan Lee, Hyeon Keun Shin, Hae Jung Son
International Journal of Surgery.2018; 60: 9. CrossRef
Anal Fistula Laser Closure: the length of fistula is the Achilles’ heel
A. Lauretta, N. Falco, E. Stocco, R. Bellomo, A. Infantino
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Video-Assisted Anal Fistula Treatment (VAAFT) for Complex Anal Fistula: A Preliminary Evaluation in China
Hui-hong Jiang, Hai-long Liu, Zhen Li, Yi-hua Xiao, A-jian Li, Yi Chang, Yong Zhang, Liang Lv, Mou-bin Lin
Medical Science Monitor.2017; 23: 2065. CrossRef
Predictive factors for recurrence of high transsphincteric anal fistula after placement of seton
Sameh Hany Emile, Hossam Elfeki, Waleed Thabet, Ahmed Sakr, Alaa Magdy, Tito M Abd El-Hamed, Waleed Omar, Wael Khafagy
Journal of Surgical Research.2017; 213: 261. CrossRef
Retrospective analysis of patients submitted to surgical treatment of perianal fistula in Santa Marcelina Hospital, São Paulo
Isaac José Felippe Corrêa Neto, Janaína Wercka, Diego Palmeira Rangel, Eduardo Augusto Lopes, Hugo Henriques Watté, Rogério Freitas Lino Souza, Alexander Sá Rolim, Laercio Robles
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Salah M. Raslan, Mohammed Aladwani, Nasser Alsanea
Annals of Saudi Medicine.2016; 36(3): 210. CrossRef
Adapting fistula surgery to fistula tract and patient condition: towards a tailored treatment
I. Pascual Miguelañez, M. Alvarez Gallego, I. Rubio Perez, T. Funes Dueñas, J. A. Gazo Martinez
European Surgery.2016; 48(1): 4. CrossRef
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Advanced Biomedical Research.2016;[Epub] CrossRef
The role of loose seton in the management of anal fistula: a multicenter study of 200 patients
M. E. Kelly, H. M. Heneghan, F. D. McDermott, G. J. Nason, C. Freeman, S. T. Martin, D. C. Winter
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Is There Any Relationship between the Chronicity of Chronic Anal Fissure and Endothelin-1?: Cheong Ho Lim, Hyeon Keun Shin, Wook Ho Kang, Seung Kyu Jeong, Hyung Kyu Yang; J Korean Soc Coloproctol. 2011;27(5):237-240. Published online October 31, 2011; DOI: https://doi.org/10.3393/jksc.2011.27.5.237

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34 Download
3 Citations

Abstract PDF

Purpose

Many kinds of substances are produced on vascular endothelial activation. The aim of this study is to confirm an increase in Endothelin-1 (ET-1), the most potent vasoconstrictor, which is produced by endothelial activation, in patients with chronic anal fissure and to infer the relationship between ET-1 and anal fissure chronicity.

Methods

The study groups are divided into three different groups with 30 subjects each. Group 1 is comprised of healthy volunteers, group 2 of chronic anal fissure patients, and Group 3 of patients with higher than 3rd degree hemorrhoids. Blood samples were taken to measure the ET-1 levels in subject's serum and to compare the results with those for the control groups.

Results

Among the 90 subjects, 38 were male, and 52 were female. The average age was 36.8. The average ET-1 level marked 1.47 ± 0.78 pg/mL for male subjects and 1.16 ± 0.47 pg/mL for female subjects (P = 0.02). The average ET-1 level in the patient groups is as follow: 1.21 ± 0.44 pg/mL in group 1, 1.46 ± 0.83 pg/mL in group 2, and 1.20 ± 0.56 pg/mL in group 3 (P = 0.14).

Conclusion

Group 2, the chronic anal fissure patient group, showed a higher ET-1 level than groups 1 and 3, the control group and the hemorrhoid patient group, but this difference had no statistical significance.

Citations

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Impact of Anal Fissure on Neuroticism, Extraversion, Openness to Experience, Agreeableness, and Conscientiousness: A Case-Control Study
Paloma Luri-Prieto, Asunción Candela-Gomis, Antonio Palazón-Bru, Felipe Navarro-Cremades, Vicente Francisco Gil-Guillén, Antonio Fernando Compañ-Rosique
Visceral Medicine.2021; 37(2): 128. CrossRef
Anatomie und Pathogenese der Analfissur
Martin Mitteregger
coloproctology.2020; 42(6): 441. CrossRef
Cost considerations in the treatment of anal fissures
Giuseppe Brisinda, Giuseppe Bianco, Nicola Silvestrini, Giorgio Maria
Expert Review of Pharmacoeconomics & Outcomes Research.2014; 14(4): 511. CrossRef

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