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Mesoglycan for pain control after open excisional HAEMOrrhoidectomy (MeHAEMO): an observational multicentre study on behalf of the Italian Society of Colorectal Surgery (SICCR)

2020; BioMed Central; Volume: 20; Issue: 1 Linguagem: Inglês

10.1186/s12893-020-00914-5

1471-2482

Gaetano Gallo, Salomone Di Saverio, Giuseppe Clerico, Alessandro Sturiale, Michele Manigrasso, Alberto Realis Luc, Mario Trompetto, G Sammarco, Francesco Ferrari, A Carpino, Giuseppe Sena, Giuseppina Vescio, Emanuela Stratta, Alberto Realis Luc, Giuseppe Clerico, Mario Trompetto, Paolo Tonello, S. Cornaglia, Vincenzo Greco, Carlo Talarico, Roberta Tutino, Nicolò Falco, Paolina Venturelli, Gianfranco Cocorullo, R Pietroletti, V. Rizza, Giovanni Milito, Michela Campanelli, Giorgio Lisi, Salvatore Brachitta, Venera Cavallaro, Giuseppe Pecorella, Bruno Turri, Diego Sasia, Maria Carmela Giuffrida, Marco Milone, Giovanni Domenico De Palma, Vincenzo Bianco, Elisabetta Moggia, Giuseppina Talamo, A. Oggianu, Michela Pili, Alessio Palumbo, Marco Fazio, Domenico Aiello, Francesco Bianco, Andrea Bondurri, Gaetano Gallo, Marco La Torre, Stefano Mancini, Giovanni Milito, Roberto Perinotti, R Pietroletti, Alberto Serventi, Marina Fiorino,

Enhanced Recovery After Surgery

Excisional haemorrhoidectomy is the gold standard technique in patients with III and IV degree haemorrhoidal disease (HD). However, it is associated with a significant rate of post-operative pain. The aim of our study was to evaluate the efficacy of mesoglycan in the post-operative period of patients who underwent open excisional diathermy haemorrhoidectomy (OEH).This was a retrospective multicentre observational study. Three hundred ninety-eight patients from sixteen colorectal referral centres who underwent OEH for III and IV HD were enrolled. All patients were followed-up on the first post-operative day (T1) and after 1 week (T2), 3 weeks (T3) and 6 weeks (T4). BMI, habits, SF-12 questionnaire, VAS at rest (VASs), after defecation (VASd), and after anorectal digital examination (VASe), bleeding and thrombosis, time to surgical wound healing and autonomy were evaluated.In the mesoglycan group, post-operative thrombosis was significantly reduced at T2 (p < 0.05) and T3 (p < 0.005), and all patients experienced less post-operative pain at each time point (p < 0.001 except for VASe T4 p = 0.003). There were no significant differences between the two groups regarding the time to surgical wound healing or post-operative bleeding. There was an early recovery of autonomy in the mesoglycan group in all three follow-up periods (T2 p = 0.016; T3 p = 0.002; T4 p = 0.007).The use of mesoglycan led to a significant reduction in post-operative thrombosis and pain with consequent early resumption of autonomy. Trial registration NCT04481698-Mesoglycan for Pain Control After Open Excisional HAEMOrrhoidectomy (MeHAEMO) https://clinicaltrials.gov/ct2/show/NCT04481698?term=Mesoglycan+for+Pain+Control+After+Open+Excisional+HAEMOrrhoidectomy+%28MeHAEMO%29&draw=2&rank=1.