Orhan BAT, Bülent KAYA, Yalim UÇTUM, Riza KUTANİŞ, Cengiz ERİŞ, Bülent SULTANOĞLU

Short And Long Term Results Of Stapled Hemorrhoidectomy Stapler

Amaç: Stapler hemoroidektomi hemoroid tedavisinde alternatif bir yöntemdir. Bu çalışmada stapler hemoroidektomi tekniğinin erken ve geç dönem sonuçlarını inceledik. Yöntem ve Gereç: Ocak 2000 ile Aralık 2009 tarihleri arasında Vakıf Gureba Eğitim ve Araştırma Hastanesinde 44 hastaya (33 erkek 11 kadın) 3 ve 4. derece hemoroid nedeni stapler hemoroidektomi uygulandı. Ortalama yaş 43 (25-72 arası) idi. Preoperatif ve postoperatif semptomlar, operasyon bilgileri, erken ve geç dönem komplikasyonlar, hastane yatış süresi ve hasta memnuniyet skorları değerlendirildi. Kayıt edilen bilgiler SSPS 13 for Windows programı ile değerlendirildi. Bulgular: Hemoroidlerin 30u (%68.1) 3. evre 14ü (%31.9) 4. evre idi. En sık preoperatif semptom [n=39 (%88.6)] rektal kanama olarak bulundu. Diğer semptomlar; perianal şişlik [n=11(%25)], ağrı [n=10 (%22.7)] ve kaşıntı [n=2 (%4.5) ] idi. Altı hasta kronik anemi bulguları ile opere edildi.Ameliyat süresi 15 ile 75 dakika arasında değişmekteydi (ortalama; 26 dakika). Perioperatif komplikasyon görülmedi. Otuz hastada (% 68.1) mukozal kanama nedeni ile hemostatik sütur uygulandı. Ondört hastada postoperatif problemler görüldü. En sık postoperatif problem 8 hastada tespit edilen idrar retansiyonuydu. Sonuç: Stapler hemoroidektomi düşük komplikasyon oranları ile etkin ve güvenilir bir cerrahi yöntemdir. Günübirlik cerrahi olarak uygulanabilir. Staplerin ateşlenmesi sonrası mukozal kanama varlığında hemostatik sutür uygulanması önerilir.

Hemoroidektomi Tekniğinin Erken Ve Geç Dönem Sonuçları

Purpose: Stapled hemorrhoidectomy is an alternative surgical technique in hemorrhoid treatment. We studied the early and long term results of stapled hemorrhoidectomy. Material and Methods: Between January 2000 and December 2009, 44 patients (33 men and 11 women) with an avarage age of 43 years (range 25 to 72) underwent stapled hemorrhoidectomy for third or fourth degree hemorrhoids in Vakif Gureba Training Hospital. Data about pre and postoperative symptoms, operation details, early and late term complications, length of hospital stay and patient satisfaction scores were collected. Statistical data is evaluated with SSPS 13 for windows. Results: Hemorrhoids were third degree in 30 patients (68.1%) and fourth degree in 14 patients (31.9%). Rectal bleeding was the most common preoperative symptom [n=39 (88.6%)]. The other symptoms were perianal swelling [n=11 ( 25%)], pain [n=10 (22.7%)] and itching [n=2 (4.5%)]. Six patients were operated with findings of chronic anemia. Operation time was ranged between 15 to 75 minutes (avarage 26 minutes). There were no perioperative complication. Haemostatic sutures for mucosal bleeding were needed in 30 cases (68.1 %). Postoperative problems were observed in 14 patients. The most common problem was urinary retention which has been detected in 8 patients. Conclusion: Stapled hemorrhoidectomy is safe, effective surgical technique with low complication rates. It can be performed in ambulatory setting. The haemostatic suturing after firing of stapler is needed and advised.

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