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High-grade hemorrhoids requiring surgical treatment are common after laparoscopic ventral mesh rectopexy

PURPOSE: To describe patients developing grade III and IV hemorrhoids requiring surgery after laparoscopic ventral mesh rectopexy (LVMR) and to explore the relationship between developing such hemorrhoids and recurrence of rectal prolapse after LVMR. METHODS: All consecutive patients receiving LVMR...

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Autores principales: van Iersel, J. J., Formijne Jonkers, H. A., Verheijen, P. M., Draaisma, W. A., Consten, E. C. J., Broeders, I. A. M. J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Milan 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4799262/
https://www.ncbi.nlm.nih.gov/pubmed/26883036
http://dx.doi.org/10.1007/s10151-016-1432-8
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author van Iersel, J. J.
Formijne Jonkers, H. A.
Verheijen, P. M.
Draaisma, W. A.
Consten, E. C. J.
Broeders, I. A. M. J.
author_facet van Iersel, J. J.
Formijne Jonkers, H. A.
Verheijen, P. M.
Draaisma, W. A.
Consten, E. C. J.
Broeders, I. A. M. J.
author_sort van Iersel, J. J.
collection PubMed
description PURPOSE: To describe patients developing grade III and IV hemorrhoids requiring surgery after laparoscopic ventral mesh rectopexy (LVMR) and to explore the relationship between developing such hemorrhoids and recurrence of rectal prolapse after LVMR. METHODS: All consecutive patients receiving LVMR at the Meander Medical Centre, Amersfoort, the Netherlands, between 2004 and 2013 were analyzed. Kaplan–Meier estimates were calculated for recurrences. RESULTS: A total of 420 patients underwent LVMR. Sixty-five of these patients (actuarial 5-year incidence 24.3, 95 % confidence interval (CI) 18.6–30.0) developed symptomatic grade III/IV hemorrhoids requiring stapled or excisional hemorrhoidectomy. Re-do surgery for recurrent grade III/IV hemorrhoids was required for 15 of the 65 patients (actuarial 5-year recurrence rate 40.6, 95 % CI 23.2–58.0) after the primary hemorrhoidectomy. Three of the 65 patients developed an external rectal prolapse (ERP) recurrence and eight an internal rectal prolapse (IRP) recurrence. This generated a 5-year recurrence rate of 25.3 % (95 % CI 0–53.9) for ERP recurrence and 24.4 % (95 % CI 9.1–39.7) for IRP recurrence. The rest of the LVMR cohort not receiving additional surgery for hemorrhoids (n = 355) showed significantly lower actuarial 5-year ERP (0.8 %, p = 0.011) and IRP (11 %, p = 0.020) recurrence rates. CONCLUSION: High-grade hemorrhoids requiring surgery may be common after LVMR. The development of high-grade hemorrhoids after LVMR might be considered a predictor of rectal prolapse recurrence.
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spelling pubmed-47992622016-04-06 High-grade hemorrhoids requiring surgical treatment are common after laparoscopic ventral mesh rectopexy van Iersel, J. J. Formijne Jonkers, H. A. Verheijen, P. M. Draaisma, W. A. Consten, E. C. J. Broeders, I. A. M. J. Tech Coloproctol Original Article PURPOSE: To describe patients developing grade III and IV hemorrhoids requiring surgery after laparoscopic ventral mesh rectopexy (LVMR) and to explore the relationship between developing such hemorrhoids and recurrence of rectal prolapse after LVMR. METHODS: All consecutive patients receiving LVMR at the Meander Medical Centre, Amersfoort, the Netherlands, between 2004 and 2013 were analyzed. Kaplan–Meier estimates were calculated for recurrences. RESULTS: A total of 420 patients underwent LVMR. Sixty-five of these patients (actuarial 5-year incidence 24.3, 95 % confidence interval (CI) 18.6–30.0) developed symptomatic grade III/IV hemorrhoids requiring stapled or excisional hemorrhoidectomy. Re-do surgery for recurrent grade III/IV hemorrhoids was required for 15 of the 65 patients (actuarial 5-year recurrence rate 40.6, 95 % CI 23.2–58.0) after the primary hemorrhoidectomy. Three of the 65 patients developed an external rectal prolapse (ERP) recurrence and eight an internal rectal prolapse (IRP) recurrence. This generated a 5-year recurrence rate of 25.3 % (95 % CI 0–53.9) for ERP recurrence and 24.4 % (95 % CI 9.1–39.7) for IRP recurrence. The rest of the LVMR cohort not receiving additional surgery for hemorrhoids (n = 355) showed significantly lower actuarial 5-year ERP (0.8 %, p = 0.011) and IRP (11 %, p = 0.020) recurrence rates. CONCLUSION: High-grade hemorrhoids requiring surgery may be common after LVMR. The development of high-grade hemorrhoids after LVMR might be considered a predictor of rectal prolapse recurrence. Springer Milan 2016-02-16 2016 /pmc/articles/PMC4799262/ /pubmed/26883036 http://dx.doi.org/10.1007/s10151-016-1432-8 Text en © The Author(s) 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Article
van Iersel, J. J.
Formijne Jonkers, H. A.
Verheijen, P. M.
Draaisma, W. A.
Consten, E. C. J.
Broeders, I. A. M. J.
High-grade hemorrhoids requiring surgical treatment are common after laparoscopic ventral mesh rectopexy
title High-grade hemorrhoids requiring surgical treatment are common after laparoscopic ventral mesh rectopexy
title_full High-grade hemorrhoids requiring surgical treatment are common after laparoscopic ventral mesh rectopexy
title_fullStr High-grade hemorrhoids requiring surgical treatment are common after laparoscopic ventral mesh rectopexy
title_full_unstemmed High-grade hemorrhoids requiring surgical treatment are common after laparoscopic ventral mesh rectopexy
title_short High-grade hemorrhoids requiring surgical treatment are common after laparoscopic ventral mesh rectopexy
title_sort high-grade hemorrhoids requiring surgical treatment are common after laparoscopic ventral mesh rectopexy
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4799262/
https://www.ncbi.nlm.nih.gov/pubmed/26883036
http://dx.doi.org/10.1007/s10151-016-1432-8
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