Estudio comparativo de la hemorroidopexia y la hemorroidectomía en el tratamiento de las hemorroides de cuarto grado

Article information

Resumen

Objetivo

El objetivo de este estudio aleatorizado ha sido comparar los resultados de la hemorroidopexia con los de la hemorroidectomía realizada con diatermia en el tratamiento de las hemorroides de cuarto grado.

Método

Se asignó de forma aleatoria a 31 pacientes con hemorroides de cuarto grado sintomáticas a 2 grupos de tratamiento: hemorroidopexia (n = 15) y hemorroidectomía con diatermia (n = 16). Se valoró el control de los síntomas un año después de la intervención.

Resultados

Ocho pacientes en el grupo de la hemorroidopexia y ninguno de los tratados con una hemorroidectomía presentaron una recidiva del prolapso (p = 0,001). Además, 6 pacientes en el grupo de la hemorroidopexia referían prurito, síntoma que sólo estaba presente en un paciente tratado con hemorroidectomía (p = 0,03) La hemorragia se resolvió igual con ambas técnicas. Por otra parte, 6 pacientes tratados mediante hemorroidopexia tenían tenesmo, síntoma que sólo estaba presente en un paciente tratado con hemorroidectomía (p = 0,007).

Conclusión

La hemorroidopexia no cura el prolapso ni el prurito en las hemorroides de cuarto grado y produce un nuevo síntoma, el tenesmo.

Palabras clave:

Hemorroides de cuarto grado

Hemorroidopexia

Hemorroidectomía

Objective

The aim of this randomized study was to compare the results of hemorrhoidopexy with those of diathermy hemorrhoidectomy in the treatment of grade IV hemorrhoids.

Method

Thirty-one patients with symptomatic grade IV hemorrhoids were randomly assigned to two treatment groups: hemorrhoidopexy (n = 15) and diathermy hemorrhoidectomy (n = 16). Symptom control 1 year after the intervention was evaluated.

Results

Prolapse recurrence occurred in eight patients in the hemorrhoidopexy group and in none in the hemorrhoidectomy group (p = 0.001). Pruritus was reported by six patients in the hemorrhoidopexy group and by only one patient in the hemorrhoidectomy group (p = 0.03). Both techniques were equally effective in resolving hemorrhage. Tenesmus was reported by six patients in the hemorrhoidopexy group and by only one patient in the hemorrhoidectomy group (p = 0.007).

Conclusion

Hemorrhoidopexy does not cure prolapse or pruritus in grade IV hemorrhoids and produces a new symptom, tenesmus.

Key words:

Grade IV hemorrhoids

Hemorrhoidopexy

Hemorrhoidectomy

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