PURPOSE: Determination of the effects of staplerhemorrhoidectomy as a new method of surgery, type of staplers and way of anal retraction on anal pressures. PATIENTS AND METHODS: In 33 patients (mean age 56 ys.) with third degree hemorrhoids who underwent staplerhemorrhoidectomy in the Marienhospital Gelsenkirchen between 1998 and 1999, anal resting and squeezing pressures were measured before and after the operation. On an average the postoperative examination was performed 47 days after operation. RESULTS: Anal resting pressures decreased significantly from 69 (23) to 58 (18) mmHg (p < 0.01) in contrast to the anal squeezing pressures (171 (60) and 170 (58) mmHg). There was a relatively greater decrease in anal resting pressure using a Parks' retractor in comparison to the use of a vaginal speculum. The decrease of resting pressure did not depend on the type of stapler used (Ethicon(c) SDH 33, n = 14 and Autosuture(c) CEEA 31, n = 19). CONCLUSION: Hemorrhoidectomy using a circular stapler leads to a significant reduction of the anal resting pressure, whereas squeezing pressures remain constant. The reduction is more pronounced if a Parks' retractor is used.
PURPOSE: Determination of the effects of staplerhemorrhoidectomy as a new method of surgery, type of staplers and way of anal retraction on anal pressures. PATIENTS AND METHODS: In 33 patients (mean age 56 ys.) with third degree hemorrhoids who underwent staplerhemorrhoidectomy in the Marienhospital Gelsenkirchen between 1998 and 1999, anal resting and squeezing pressures were measured before and after the operation. On an average the postoperative examination was performed 47 days after operation. RESULTS: Anal resting pressures decreased significantly from 69 (23) to 58 (18) mmHg (p < 0.01) in contrast to the anal squeezing pressures (171 (60) and 170 (58) mmHg). There was a relatively greater decrease in anal resting pressure using a Parks' retractor in comparison to the use of a vaginal speculum. The decrease of resting pressure did not depend on the type of stapler used (Ethicon(c) SDH 33, n = 14 and Autosuture(c) CEEA 31, n = 19). CONCLUSION: Hemorrhoidectomy using a circular stapler leads to a significant reduction of the anal resting pressure, whereas squeezing pressures remain constant. The reduction is more pronounced if a Parks' retractor is used.