Skip to main content
SpringerLink
Log in

Long term results after stapled anopexy for symptomatic haemorrhoidal prolapse

Langzeitergebnisse nach "Anopexie nach Longo" bei symptomatischem Hämorrhoidalprolaps

  • Original Scientific Paper
  • Published:
European Surgery Aims and scope Submit manuscript

Zusammenfassung

GRUNDLAGEN: Ziel dieser Studie war eine Langzeitbeurteilung der Effektivität der Anopexie nach Longo bei symptomatischem Hämorrhoidalprolaps. METHODIK: 242 Patienten (mittlere Follow-up-Dauer 48 Monate) wurden inkludiert. Zur Evaluierung klinischer Symptome (Schmerzen, Jucken, Blutung, Stuhldrang, Stuhlinkontinenz) und Patientenzufriedenheit wurde ein standardisierter Fragebogen entworfen. Zudem wurde zur anatomischen Beuteilung eine klinische Untersuchung durchgeführt. ERGEBNISSE: Postoperativ beurteilten 79,4% der Patienten ihr Ergebnis mit "sehr gut", 12% "gut", 5,7% "ausreichend" und 2,9% "schlecht". 5 Patienten (2,1%) zeigten einen erneuten Hämorrhoidalprolaps und wurden nach Milligan-Morgan nachoperiert. Äußere anale Hautfalten (Marisken) wurden in 26,9% (n = 65) beobachtet. Erneut aufgetretene Symptome waren Blutungen in 7,9% (n = 19), Juckreiz in 4,1% (n = 10) und Schmerzen in 3,3% (n = 8). Chirurgische Nebenwirkungen waren Stuhldrang in 4,5% (n = 11), Stuhlinkontinenz in 3,3% (n = 8) und anhaltender Schmerz in 3,3% (n = 8). SCHLUSSFOLGERUNGEN: Trotz einer höheren Anzahl an verbliebenen äußeren analen Hautfalten konnte die Studie eine hohe Patientenzufriedenheit sowie eine akzeptable Beseitigung von Hämorrhoidalbeschwerden auch im Langzeit- Follow-up aufzeigen.

Summary

BACKGROUND: Because of a lack of long-term results, the present study was designed to assess the effectiveness of stapled anopexy after long-term follow-up. METHODS: 242 of 300 operated patients were available for follow-up (mean 48 months). For evaluation, a standardized questionnaire was used, including clinical symptoms and satisfaction. Anal anatomy was assessed by clinical examination. RESULTS: Patients judged their results as excellent in 79.4%, good in 12%, fair in 5.7% and poor in 2.9% cases. Five patients (2.1%) showed recurrent prolapse and were operated by Milligan-Morgan procedure. Residual skin-tags were observed in 26.9% (n = 65). Reoccurrence of haemorrhoidal symptoms were bleeding (7.9%), itching (4.1%) and pain (3.3%). Adverse effects of surgery were stool urgency (4.5%), faecal incontinence (3.3%) and persistent pain (0.8%). CONCLUSIONS: Despite a high rate of residual skin-tags after stapled anopexy, our data revealed acceptable results in terms of patient's satisfaction and definitive resolution of haemorrhoidal symptoms after a long term follow-up.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  • Longo A (1998) Treatment of haemorrhoids disease by reduction of mucosa and hemorrhoidal prolaps with circular suturing device: a new procedure. World Congress of Endoscopic Surgery, Rome, Italy

  • Hetzer FH, Demartines N, Handschin AE, Clavien PA (2002) Stapled vs excision hemorrhoidectomy: long-term results of a prospective randomized trial. Arch Surg 137: 337–340

    Article  PubMed  Google Scholar 

  • Kairaluoma M, Nuorva K, Kellokumpu I (2003) Day-case stapled (circular) vs. diathermy hemorrhoidectomy: a randomized, controlled trial evaluating surgical and functional outcome. Dis Colon Rectum 46: 93–99

    Article  PubMed  Google Scholar 

  • Mehigan BJ, Monson JR, Hartley JE (2000) Stapling procedure for haemorrhoids versus Milligan-Morgan haemorrhoidectomy: randomised controlled trial. Lancet 355 (9206): 782–785

    Article  PubMed  CAS  Google Scholar 

  • Rowsell M, Bello M, Hemingway DM (2000) Circumferential mucosectomy (stapled haemorrhoidectomy) versus conventional haemorrhoidectomy: randomised controlled trial. Lancet 355 (9206): 779–781

    Article  PubMed  CAS  Google Scholar 

  • Senagore AJ, Singer M, Abcarian H, Fleshman J, Corman M, Wexner S, et al. (2004) A prospective, randomized, controlled multicenter trial comparing stapled hemorrhoidopexy and Ferguson hemorrhoidectomy: perioperative and one-year results. Dis Colon Rectum 47: 1824–1836

    Article  PubMed  CAS  Google Scholar 

  • Ganio E, Altomare DF, Milito G, Gabrielli F, Canuti S (2007) Long-term outcome of a multicentre randomized clinical trial of stapled haemorrhoidopexy versus Milligan-Morgan haemorrhoidectomy. Br J Surg 94: 1033–1037

    Article  PubMed  CAS  Google Scholar 

  • Van de Stadt J, D'Hoore A, Duinslaeger M, Chasse E, Penninckx F (2005) Long-term results after excision haemorrhoidectomy versus stapled haemorrhoidopexy for prolapsing haemorrhoids; a Belgian prospective randomized trial. Acta Chir Belg 105: 44–52

    PubMed  CAS  Google Scholar 

  • Banov L Jr, KLJ, Erdman LH, Alia RT (1985) Management of hemorrhoidal disease. J S C Med Assoc 81: 398–401

    PubMed  Google Scholar 

  • Draxler W, Mittelböck M (2006) Basic principles in the planning of clinical trials in surgical oncology. Eur Surg 38: 27–32

    Article  Google Scholar 

  • Bonner C, Prohm P, Storkel S (2001) Fournier gangrene as a rare complication after stapler hemorrhoidectomy. Case report and review of the literature. Chirurg 72: 1464–1466

    Article  PubMed  CAS  Google Scholar 

  • Molloy RG, Kingsmore D (2000) Life threatening pelvic sepsis after stapled haemorrhoidectomy. Lancet 355 (9206): 810

    Article  PubMed  CAS  Google Scholar 

  • Pescatori M, Aigner F (2007) Stapled transanal rectal mucosectomy ten years after. Tech Coloproctol 11: 1–6

    Article  PubMed  CAS  Google Scholar 

  • Ripetti V, Caricato M, Arullani A (2002) Rectal perforation, retropneumoperitoneum, and pneumomediastinum after stapling procedure for prolapsed hemorrhoids: report of a case and subsequent considerations. Dis Colon Rectum 45: 268–270

    Article  PubMed  Google Scholar 

  • Thaha MA, Irvine LA, Steele RJ, Campbell KL (2005) Postdefaecation pain syndrome after circular stapled anopexy is abolished by oral nifedipine. Br J Surg 92: 208–210

    Article  PubMed  CAS  Google Scholar 

  • Fueglistaler P, Guenin MO, Montali I, Kern B, Peterli R, von Flue M, et al. (2007) Long-term results after stapled hemorrhoidopexy: high patient satisfaction despite frequent postoperative symptoms. Dis Colon Rectum 50: 204–212

    Article  PubMed  CAS  Google Scholar 

  • Ng KH, Ho KS, Ooi BS, Tang CL, Eu KW (2006) Experience of 3711 stapled haemorrhoidectomy operations. Br J Surg 93: 226–230

    Article  PubMed  Google Scholar 

  • Cheetham MJ, Mortensen NJ, Nystrom PO, Kamm MA, Phillips RK (2000) Persistent pain and faecal urgency after stapled haemorrhoidectomy. Lancet 356 (9231): 730–733

    Article  PubMed  CAS  Google Scholar 

  • Ho YH, Seow-Choen F, Tsang C, Eu KW (2001) Randomized trial assessing anal sphincter injuries after stapled haemorrhoidectomy. Br J Surg 88: 1449–1455

    Article  PubMed  CAS  Google Scholar 

  • Jayaraman S, Colquhoun PH, Malthaner RA (2006) Stapled versus conventional surgery for hemorrhoids. Cochrane Database Syst Rev (4): CD005393

  • Smyth EF, Baker RP, Wilken BJ, Hartley JE, White TJ, Monson JR (2003) Stapled versus excision haemorrhoidectomy: long-term follow up of a randomised controlled trial. Lancet 361 (9367): 1437–1438

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of General Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria

    S. Riss & P. Riss

  2. Department of Surgery, Hartmannspital, Vienna, Austria

    M. Schuster & T. Riss

Authors
  1. S. Riss
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. P. Riss
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. Schuster
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. T. Riss
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to S. Riss.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Riss, S., Riss, P., Schuster, M. et al. Long term results after stapled anopexy for symptomatic haemorrhoidal prolapse. Eur Surg 40, 30–33 (2008). https://doi.org/10.1007/s10353-007-0377-6

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10353-007-0377-6

Schlüsselwörter

Keywords

Search

Navigation