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Surgery Research and Practice
Volume 2014, Article ID 710128, 7 pages
Clinical Study

Residual Prolapse in Patients with III-IV Degree Haemorrhoids Undergoing Stapled Haemorrhoidopexy with CPH34 HV: Results of an Italian Multicentric Clinical Study

1Coloproctology Unit, Casa di Cura San Camillo, Forte dei Marmi, Lucca, Italy
2General Surgery and Breast Unit, IRCCS “San Martino-IST”, L.go R. Benzi 10, 16132 Genoa, Italy
3Casa di Cura Triolo-Zancla, Palermo, Italy
4Colo-Proctology Unit, San Camillo Hospital, Rome, Italy
5General Surgery, Villa Paideia Hospital, Rome, Italy
6General Surgery, Celio Military Hospital, Rome, Italy
7General Surgery, Policlinico Umberto I, Rome, Italy
8General Surgery, San Carlo IDI Hospital, Rome, Italy
9General Surgery, Fatebenefratelli Hospital, Rome, Italy

Received 18 February 2014; Revised 28 April 2014; Accepted 18 May 2014; Published 15 June 2014

Academic Editor: Frank A. Frizelle

Copyright © 2014 Giuliano Reboa et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


CPH34 HV, a high volume stapler, was tested in order to assess its safety and efficacy in reducing residual/recurrent haemorrhoids. The clinical charts of 430 patients with third- to fourth-degree haemorrhoids undergoing SH in 2012-2013 were consecutively reviewed, excluding those with obstructed defecation (rectocele >2 cm; Wexner’s score >15). Follow-up was scheduled at six and 12 months. Rectal prolapse exceeding more than half of CAD was reported in 341 patients (79.3%); one technical failure was reported (0.2%) without any serious untoward effect; and 1.3 stitch/patient (SD, 1.7) was required to achieve complete haemostasis. Doughnuts volume was higher (13.8 mL; SD, 1.5) in patients with a large rectal prolapse than with smaller one (8.9 mL; SD, 0.7) ( value <0.05). Residual and recurrent haemorrhoids occurred in 8 of 430 patients (1.8%) and 5 of 254 patients (1.9%), respectively. A high index of patient satisfaction (visual analogue scale = 8.9; SD, 0.9) coupled with a persistent reduction of constipation scores (CSS = 5.0, SD, 2.2) was observed. The wider prolapse resection well correlated with a clear-cut reduction of haemorrhoidal relapse, a high index of patient satisfaction, and clinically relevant reduction of constipations scores coupled with satisfactory haemostatic properties of CPH34 HV.