Immediate and long-term results of Whitehead’s operation

DOI: https://doi.org/10.29296/25877305-2019-05-17
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Issue: 
5
Year: 
2019

M. Danilov, Candidate of Medical Sciences; A. Atroshchenko, Candidate of Medical Sciences; S. Pozdnyakov; G. Saakyan, I. Dolgopyatov; A. Nikolaeva A.S. Loginov Moscow Clinical Research Center, Moscow Healthcare Department, Moscow

The immediate and long-term results of hemorrhoidectomies were assessed using the modified Whitehead procedure. The indication for this surgical treatment were grade IV circular hemorrhoids (patients who had undergone open or closed hemorrhoidectomy with preservation of mucocutaneous bridges) would be associated with leaving hemorrhoidal tissue. Twenty hemorrhoidectomies were performed using a modified Whitehead’s technique (in 12 women and 8 men; the mean age of the patients was 38.7±9.4 years; the mean follow-up period after surgery was 9.5 months). Whitehead’s hemorrhoidectomy (its traditional or modified version) is not the operation of choice for grade III–IV hemorrhoid disease; however, but in some cases it may have clear advantages over traditional procedures, i.e. it is unassociated with an increase in the frequency of postoperative complications (bleeding, suppuration, stricture, incontinence) and with the occurrence of recurrent disease.
Keywords: 
surgery
Whitehead’s surgery
hemorrhoidectomy

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References: 
  1. Shelygin Ju.A., Blagodarnyj L.A., Hmylov L.M. Vybor sposoba gemorroidektomii pri hronicheskom gemorroe // Hirurgija. – 2003; 3: 39–45 [Shelygin Yu.A., Blagodarnyi L.A., Khmylov L.M. Vybor sposoba gemorroidektomii pri khronicheskom gemorroe // Khirurgiya. – 2003; 3: 39–45 (in Russ.)].
  2. Higuero T., Abramowitz L., Castinel A. et al. Guidelines for the treatment of hemorrhoids (short report) // J. Visc. Surg. – 2016; 153 (3): 213–8.
  3. Riss S., Weiser F., Schwameis K. et al. The prevalence of hemorrhoids in adults // Int. J. Colorectal. Dis. – 2012; 27 (2): 215–20.
  4. 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): 105–13.
  5. Aigner F., Bodner G., Gruber H. et al. The vascular nature of hemorrhoids // J. Gastrointest. Surg. – 2006; 10 (7): 1044–50.
  6. Thomson W. The nature of haemorrhoids // Br. J. Surg. – 1975; 62 (7): 542–52.
  7. Chang S.-C., Shih J., Lee H. Review of Treitz’s Muscles and their implications in a hemorrhoidectomy and hemorrhoidopexy // Fu-Jen Journal of Medicine. – 2006; 4 (1): 1–6.
  8. Whitehead W. The Surgical Treatment of Haemorrhoids // Br. Med. J. – 1882; 1 (1101): 148–50.
  9. Rand A. Whitehead’s radical circumferential hemorrhoidectomy modified by sliding skin-flap grafts // Surg. Clin. North Am. – 1972; 52 (4): 1031–45.
  10. Devien C. Death to Whitehead, hurray for Toupet! or total circular hemorrhoidectomy revisited. Its technique, their indications and their results // Ann. Chir. – 1994; 48 (6): 565–71.
  11. Mukhashavria G., Qarabaki M. Surgical technique tailored to advanced haemorrhoids // Tech. Coloproctol. – 2009; 13 (2): 151–5; discussion 5.
  12. Mehigan B., Monson J., Hartley J. Stapling procedure for haemorrhoids versus Milligan-Morgan haemorrhoidectomy: randomised controlled trial // Lancet. – 2000; 355 (9206): 782–5.
  13. Senagore A., Singer M., Abcarian H. et al. A prospective, randomized, controlled multicenter trial comparing stapled hemorrhoidopexy and Ferguson hemorrhoidectomy: perioperative and one-year results // Dis. Colon. Rectum. – 2004; 47 (11): 1824–36.
  14. Mal'kavi M.M. Sravnitel'nye rezul'taty hirurgicheskogo lechenija hronicheskogo gemorroja IV stadii // Vestnik KRSU. – 2016; 7: 29–32 [Malkawi M.M. Comparative results of surgical treatment of stage IV hemorrhoids // Vestnik KRSU. – 2016; 7: 29–32 (in Russ)].
  15. Maria G., Alfonsi G., Nigro C. et al. Whitehead’s hemorrhoidectomy. A useful surgical procedure in selected cases // Tech. Coloproctol. – 2001; 5 (2): 93–6.
  16. Abramowitz L., Godeberge P., Staumont G. et al. Clinical practice guidelines for the treatment of hemorrhoid disease // Gastroenterol. Clin. Biol. – 2001; 25 (6–7): 674–702.
  17. Kim J. Analysis of surgical treatments for circumferentially protruding haemorrhoids: complete excision with repair using flaps versus primary excision with secondary suture-ligation // Asian J. Surg. – 2006; 29 (3): 128–34.
  18. Mukhashavria G., Qarabaki M. Circumferential excisional hemorrhoidectomy for extensive acute thrombosis: a 14-year experience // Dis. Colon. Rectum. – 2011; 54 (9): 1162–9.
  19. Kraemer M. Whitehead hemorrhoidectomy in older patients // Tech. Coloproctol. – 2000; 4: 79–81.
  20. Zherlov G.K., Zykov D.V., Karpovich A.V. i dr. Hirurgicheskoe lechenie gemorroja // Hirurgija. Zhurn. im. N.I. Pirogova. – 2008; 9: 19–24 [Zherlov G.K., Zykov D.V., Karpovich A.V. et al. Surgical treatment of haemorrhoids // Khirurgiya. Zhurn. im. N.I. Pirogova. – 2008; 9: 19–24 (in Russ.)].
  21. Altomare D., Giuratrabocchetta S. Conservative and surgical treatment of haemorrhoids // Nat. Rev. Gastroenterol. Hepatol. – 2013; 10 (9): 513–21.
  22. Palazzo F., Francis D., Clifton M. Randomized clinical trial of Ligasure versus open haemorrhoidectomy // Br. J. Surg. – 2002; 89 (2): 154–7.
  23. Cerato M., Cerato N., Passos P. et al. Surgical treatment of hemorrhoids: a critical appraisal of the current options // Arq. Bras. Cir. Dig. – 2014; 27 (1): 66–70.