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A Novel Technique for the Haemorrhoids Treatment: Stapled Transanal Resection of the Rectum (STARR)

Khalid Khairi Hussein
Tikrit University College of medicine, Iraq
Akram Mohammed Ali
Independent researcher, Iraq
Mudhafar Razzaq Hayyawi
Alshatra general hospital, Thi-qar health director, Iraq

Abstract

Aim: Haemorrhoids means swellings of the anal crossings which means small, bleeds and thrombose and many prolapse these gives bleed clinical symptoms. The purpose of this trial is to evaluate the use and benefits of the STARR procedure along with its drawbacks, if any. The efficacy, safety and its postoperative management were also recorded. Material and methods: A prospective clinical trial was performed. The patients (n = 40) visiting to the hospital were enrolled in the study. From each patient, informed consent was taken before enrollment in the study. A day before surgery, routine rectal clearance was done using water enema with castor oil. Antibiotics ceftriaxone 1gm IV and metronidazol (500mg) were given during induction prophylactically. Results: Around 29 (75%) males and 11 (25%) females were enrolled in the study. Their mean age was 41 years. Around 32 (82%) and 8 (18%) patients showed grade III and grade IV, respectively. Prolapsed piles (IV) being the most frequent presentation (25 patients, i.e. 69%). Mean operating time was 25 minutes, while the mean hospital stay was 1.5 days. All the patients were as elective cases, no day case was operated upon noticeable complications. Urine retention notified in 3% patients (7%) and around 2 patients showed perianal itching (5%). However, it was temporary. Around 38 (96%) patients reported normal defecation. Only one patient (4%) reported occasional mild staining. Around 38 (95%) patients did not report itching. About 4 patients reported occasionally itching (once in a day). Conclusions: The recent introduced methods of hemorrhoidectomy, SH to our country proved to be effective and safe in managing grade III and IV hemorrhoids. It is a safe surgical alternative and the procedure has few postoperative communications, short hospital stays with minimal perianal pain.

Keywords: Haemorrhoides, Haemorrhoidectomy, Clinical trial, Postoperative management ,

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