Research progress of modern minimally invasive surgery for hemorrhoids_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 XU Zhengrong ,  XIAO Qing

Department of Surgery, Hospital of PLA Unit 63820, Mianyang, Sichuan 621000, P. R. China;

Corresponding?author：

XIAO Qing, Email: 13981176708@163.com

Keywords：

hemorrhoid; surgical treatment; minimally invasive surgery

DOI：

10.7507/1007-9424.202103137

Video：

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Objective To summarize the modern minimally invasive surgical treatment of hemorrhoids and related clinical research progress.Method Literatures on minimally invasive surgery for hemorrhoids at home and abroad in recent years were collected and reviewed.Results The modern minimally invasive operation of hemorrhoids can be divided into three types. One was for bleeding symptoms to reduce blood supply of hemorrhoids artery for blood vessel block operation; the second one was for prolapse symptoms to restore anal pad anatomical position based on the mucosal resection; the third one was for pain itch symptoms to remove the proliferation of tissue mass based hemorrhoidectomy. All kinds of operations extended to different modified or combined operations. Under the premise of reasonable selection of patients, minimally invasive surgery for hemorrhoids was safe and effective.Conclusions With the rapid development of modern minimally invasive surgery technology and surgical instruments, the surgical treatment of hemorrhoids has been constantly innovated. Any kind of minimally invasive surgery for hemorrhoids has its specific indications and limitations. Therefore, we should pay attention to symptomatic treatment and comprehensive treatment, in order to better play the advantages of minimally invasive surgery for hemorrhoids.

Citation： XU Zhengrong, XIAO Qing. Research progress of modern minimally invasive surgery for hemorrhoids. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2022, 29(2): 274-280. doi: 10.7507/1007-9424.202103137 Copy

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3.	Loder PB, Kamm MA, Nicholls RJ, et al. Haemorrhoids: pathology, pathophysiology and aetiology. Br J Surg, 1994, 81(7): 946-954.
4.	Morgado PJ, Suárez JA, Gómez LG, et al. Histoclinical basis for a new classification of hemorrhoidal disease. Dis Colon Rectum, 1988, 31(6): 474-480.
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23.	Han X, Xia F, Chen G, et al. Superior rectal artery embolization for bleeding internal hemorrhoids. Tech Coloproctol, 2021, 25(1): 75-80.
24.	Kü?ükay MB, Kü?ükay F. Superior rectal artery embolization with tris-acryl gelatin microspheres: a randomized comparison of particle size. J Vasc Interv Radiol, 2021, 32(6): 819-825.
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1. Peery AF, Crockett SD, Barritt AS, et al. Burden of gastrointestinal, liver, and pancreatic diseases in the United States. Gastroenterology, 2015, 149(7): 1731-1741.
2. 江維, 張虹璽, 隋楠, 等. 中國城市居民常見肛腸疾病流行病學調查. 中國公共衛生, 2016, 32(10): 1293-1296.
3. Loder PB, Kamm MA, Nicholls RJ, et al. Haemorrhoids: pathology, pathophysiology and aetiology. Br J Surg, 1994, 81(7): 946-954.
4. Morgado PJ, Suárez JA, Gómez LG, et al. Histoclinical basis for a new classification of hemorrhoidal disease. Dis Colon Rectum, 1988, 31(6): 474-480.
5. Aigner F, Gruber H, Conrad F, et al. Revised morphology and hemodynamics of the anorectal vascular plexus: impact on the course of hemorrhoidal disease. Int J Colorectal Dis, 2009, 24(1): 105-113.
6. Chung YC, Hou YC, Pan AC. Endoglin (CD105) expression in the development of haemorrhoids. Eur J Clin Invest, 2004, 34(2): 107-112.
7. 中華醫學會外科學分會結直腸肛門外科學組, 中華中醫藥學會肛腸病專業委員會, 中國中西醫結合學會結直腸肛門病專業委員會. 痔臨床診治指南(2006 版). 中華胃腸外科雜志, 2006, 9(5): 461-463.
8. Nisar PJ, Scholefield JH. Managing haemorrhoids. BMJ, 2003, 327(7419): 847-851.
9. Buntzen S, Christensen P, Khalid A, et al. Diagnosis and treatment of haemorrhoids. Dan Med J, 2013, 60(12): C4754.
10. 羅春生, 賈一平, 楊巍, 等. 超選擇動脈栓塞術治療痔病 3 例初探. 介入放射學雜志, 2016, 25(12): 1089-1093.
11. Morinaga K, Hasuda K, Ikeda T. A novel therapy for internal hemorrhoids: ligation of the hemorrhoidal artery with a newly devised instrument (Moricorn) in conjunction with a Doppler flowmeter. Am J Gastroenterol, 1995, 90(4): 610-613.
12. De Nardi P, Capretti G, Corsaro A, et al. A prospective, randomized trial comparing the short- and long-term results of doppler-guided transanal hemorrhoid dearterialization with mucopexy versus excision hemorrhoidectomy for grade Ⅲ hemorrhoids. Dis Colon Rectum, 2014, 57(3): 348-353.
13. Simillis C, Thoukididou SN, Slesser AA, et al. Systematic review and network meta-analysis comparing clinical outcomes and effectiveness of surgical treatments for haemorrhoids. Br J Surg, 2015, 102(13): 1603-1618.
14. Brown SR, Tiernan JP, Watson AJM, et al. Haemorrhoidal artery ligation versus rubber band ligation for the management of symptomatic second-degree and third-degree haemorrhoids (HubBLe): a multicentre, open-label, randomised controlled trial. Lancet, 2016, 388(10042): 356-364.
15. Davis BR, Lee-Kong SA, Migaly J, et al. The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Hemorrhoids. Dis Colon Rectum, 2018, 61(3): 284-292.
16. 林暉, 朱吉, 歸玉瓊, 等. 痔動脈結扎肛墊懸吊外剝術與 Milligan-Morgan 術對痔上動脈分支及血流速度影響的臨床研究. 中華結直腸疾病電子雜志, 2020, 9(3): 265-269.
17. 林暉, 王琛, 張少軍, 等. 痔動脈結扎肛墊懸吊外剝術治療Ⅲ~Ⅳ度混合痔的多中心隨機對照研究. 結直腸肛門外科, 2020, 26(2): 196-201.
18. Pucher PH, Sodergren MH, Lord AC, et al. Clinical outcome following Doppler-guided haemorrhoidal artery ligation: a systematic review. Colorectal Dis, 2013, 15(6): e284-e294.
19. Schuurman JP, Go PM, Bleys RL. Anatomical branches of the superior rectal artery in the distal rectum. Colorectal Dis, 2009, 11(9): 967-971.
20. Vidal V, Louis G, Bartoli JM, et al. Embolization of the hemorrhoidal arteries (the emborrhoid technique): a new concept and challenge for interventional radiology. Diagn Interv Imaging, 2014, 95(3): 307-315.
21. Zakharchenko A, Kaitoukov Y, Vinnik Y, et al. Safety and efficacy of superior rectal artery embolization with particles and metallic coils for the treatment of hemorrhoids (Emborrhoid technique). Diagn Interv Imaging, 2016, 97(11): 1079-1084.
22. 羅春生, 賈一平, 茅愛武, 等. 經血管超選擇直腸上動脈栓塞治療痔病的初步臨床分析. 中華醫學雜志, 2017, 97(25): 1960-1963.
23. Han X, Xia F, Chen G, et al. Superior rectal artery embolization for bleeding internal hemorrhoids. Tech Coloproctol, 2021, 25(1): 75-80.
24. Kü?ükay MB, Kü?ükay F. Superior rectal artery embolization with tris-acryl gelatin microspheres: a randomized comparison of particle size. J Vasc Interv Radiol, 2021, 32(6): 819-825.
25. Tradi F, Mege D, Louis G, et al. Emborrhoid: rectal arteries embolization for hemorrhoid treatment. Presse Med, 2019, 48(4): 454-459.
26. 周慶健, 盧潤廣. M-M 與 RPH 治療環狀混合痔的臨床療效及并發癥比較. 結直腸肛門外科, 2018, 24(1): 45-49.
27. Shanmugam V, Thaha MA, Rabindranath KS, et al. Systematic review of randomized trials comparing rubber band ligation with excisional haemorrhoidectomy. Br J Surg, 2005, 92(12): 1481-1487.
28. Peng BC, Jayne DG, Ho YH. Randomized trial of rubber band ligation vs. stapled hemorrhoidectomy for prolapsed piles. Dis Colon Rectum, 2003, 46(3): 291-297.
29. Iyer VS, Shrier I, Gordon PH. Long-term outcome of rubber band ligation for symptomatic primary and recurrent internal hemorrhoids. Dis Colon Rectum, 2004, 47(8): 1364-1370.
30. Thomson WH. The nature of haemorrhoids. Br J Surg, 1975, 62(7): 542-552.
31. Thomson WH. The nature and cause of haemorrhoids. Proc R Soc Med, 1975, 68(9): 574-575.
32. Yeo D, Tan KY. Hemorrhoidectomy—making sense of the surgical options. World J Gastroenterol, 2014, 20(45): 16976-16983.
33. Longo A. Treatment of haemorrhoids disease by reduction of mucosa and haemorrhoidal prolapse with a circular-suturing device: a new procedure. Proceedings of the 6th World Congress of Endoscopic Surgery. Rome, 1998: 777-784.
34. 賀平, 陳宏亮. 吻合器痔上粘膜環切釘合術與 Milligan-Morgan 術隨機對照試驗的系統評價與 meta-分析. 第十八屆中國中西醫結合學會大腸肛門病專業委員會學術會議暨甘肅省第五屆結直腸肛門外科學術年會. 蘭州: 2015.
35. 張慧嫦, 熊秋華, 羅秀瓊. PPH 聯合部分肛門內括約肌切斷術應用于重度混合痔并直腸肛管靜息壓高壓患者的療效觀察. 中國普外基礎與臨床雜志, 2020, 27(4): 454-459.
36. Porrett LJ, Porrett JK, Ho YH. Documented complications of staple hemorrhoidopexy: a systematic review. Int Surg, 2015, 100(1): 44-57.
37. Lai HJ, Jao SW, Su CC, et al. Stapled hemorrhoidectomy versus conventional excision hemorrhoidectomy for acute hemorrhoidal crisis. J Gastrointest Surg, 2007, 11(12): 1654-1661.
38. Lin HC, Lian L, Xie SK, et al. The tissue-selecting technique: segmental stapled hemorrhoidopexy. Dis Colon Rectum, 2013, 56(11): 1320-1324.
39. 范雷濤, 孫源, 李春雨. 比較兩種聯合術式治療混合痔的臨床療效和肛腸動力學變化. 中國普外基礎與臨床雜志, 2021, 28(1): 79-84.
40. Leung ALH, Cheung TPP, Tung K, et al. A prospective randomized controlled trial evaluating the short-term outcomes of transanal hemorrhoidal dearterialization versus tissue-selecting technique. Tech Coloproctol, 2017, 21(9): 737-743.
41. Lin HC, Luo HX, Zbar AP, et al. The tissue selecting technique (TST) versus the Milligan-Morgan hemorrhoidectomy for prolapsing hemorrhoids: a retrospective case-control study. Tech Coloproctol, 2014, 18(8): 739-744.
42. Lin HC, He QL, Shao WJ, et al. Partial stapled hemorrhoidopexy versus circumferential stapled hemorrhoidopexy for grade Ⅲ to Ⅳ prolapsing hemorrhoids: a randomized, noninferiority trial. Dis Colon Rectum, 2019, 62(2): 223-233.
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