Retrospective Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jan 27, 2015; 7(1): 10-14
Published online Jan 27, 2015. doi: 10.4240/wjgs.v7.i1.10
Vascular Z-shaped ligation technique in surgical treatment of haemorrhoid
Kazım Gemici, Ahmet Okuş, Serden Ay
Kazım Gemici, Ahmet Okuş, Department of General Surgery, Faculty of Medicine, Mevlana University, 42200 Konya, Turkey
Serden Ay, Department of General Surgery, Muş Malazgirt State Hospital, 49400 Muş, Turkey
Author contributions: All authors contributed to this manuscript.
Ethics approval: The study was reviewed and approved by the Mevlana University Faculty of Medicine Institutional Review Board.
Informed consent: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest: There is no conflict of interest between the authors.
Data sharing: Technical appendix, statistical code, and dataset available from the corresponding author at drkazimgemici@hotmail.com. Participants gave informed consent for data sharing.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Kazım Gemici, MD, Department of General Surgery, Faculty of Medicine, Mevlana University, Aksinne Mahallesi Esmetaş Sokak No:16, Meram, 42200 Konya, Turkey. drkazimgemici@hotmail.com
Telephone: +90-44-44200 Fax: +90-33-23205630
Received: October 24, 2014
Peer-review started: October 24, 2014
First decision: November 27, 2014
Revised: December 22, 2014
Accepted: December 29, 2014
Article in press: January 4, 2015
Published online: January 27, 2015
Abstract

AIM: To present the effectiveness of minimal invasive vascular zet ligation in the surgical treatment of haemorrhoidal disease (HD).

METHODS: Among 138 patients with 2nd-4th grade internal HD having several complaints and operated at our hospital between 2003-2013; 116 patients who regularly attended 1-year control were included in the study. Operation times, postoperative early period pain, satisfaction score, complications and relapse details were obtained from computer records retrospectively. Visual Analogous Scale (VAS) scores were used for patient satisfaction on the 3rd, 7th and 21st days. Technique; fixed suture which is constituted by the first leg of the Z-shaped suture (to pass by the mucosa and muscular layer) was put in the pile root in order to ensure vascular ligation and fixation. The second leg of the Z-shaped suture is constituted by mobile suture and it passes by the pile mucosa and submucosa which prolapses 5-10 mm below the first suture.

RESULTS: Seventy-five of the patients (65%) were male, 41 of them (35%) were female and their age average was 41. The mean operation time was 12 ± 4.8 min. VAS/satisfaction score was found as 2.2/4.3, 1.8/4.0, 1.2/4.4 respectively on the 3rd, 7th, and 21st days. Four of the patient (3.5%) had relapse.

CONCLUSION: This technique is an easily applicable, cost efficient way of operation which increases patient satisfaction.

Keywords: Haemorrhoids, Haemorrhoidectomy, Z ligation

Core tip: The non surgical and surgical therapy of symptomatic hemorrhoidal disease, cannot achieve the same results at each patient. The vascular Z suture technique, is an innovative technique employed in the surgical therapy of symptomatic haemorrhoid of 3-4 degree. This technique is reducing significantly the complications which are annoying both the postoperative patient and the surgeon. The product of ten years experience and development, this technique has a facile application and increases the postoperative life quality of the patient. The most distinctive and highest qualities of this technique are embed in the shortness of the operation time, easy applicability and reduction in the postoperative bleeding and pain symptoms of the patient as well as a shorter recovery period.