Prospective, randomized trial comparing a 3- versus 6-stitch purse-string suture in stapled hemorrhoidopexy

Yasuhiro Inoue, Minako Kobayashi, Shigeyuki Yoshiyama, Junichiro Hiro, Masaki Ohi, Chikao Miki, Masato Kusunoki

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)


Aim: The purse-string suture is the most important part of the procedure in stapled hemorrhoidopexy affecting resection of an ideal mucosal rectal ring. We designed a prospective, randomized study to evaluate the safety and clinical outcome of a 6-stitch purse-string suture compared with a more simple 3-stitch purse-string suture intended to achieve certain interruption of the hemorrhoidal artery. Methods: Ninety patients were randomly assigned to undergo stapled hemorrhoidopexy with either a 6-stitch (n = 45) or a 3-stitch (n = 45) purse-string suture. Operative data and postoperative complications were compared between the 2 groups. The ring of excised rectal mucosa was examined histologically. Anal physiology was also assessed. Results: Although there were no statistically significant differences in postoperative complication rates, histological analysis of the excised mucosa, or anorectal function between the 2 groups, the 3-stitch procedure was significantly superior to the 6-stitch procedure in terms of intraoperative hemostasis and operative time, especially in advanced surgery. Conclusion: Once the learning curve has been completed, a 3-stitch purse-string suture in stapled hemorrhoidopexy could be an alternative to the 6-stitch suture, with effective hemostasis and a shorter operative time.

Original languageEnglish
Pages (from-to)382-387
Number of pages6
JournalDigestive Surgery
Issue number5
Publication statusPublished - 10-2007
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Surgery
  • Gastroenterology


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