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Rectal Stenosis after Procedures for Prolapse and Hemorrhoids (PPH)—A Report from China

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Abstract

Objectives

After it was introduced in China in 2000, the surgical procedure for prolapse and hemorrhoids (PPH) has become a widely accepted for third- and fourth-degree hemorrhoids. Stenosis of the lower rectum is one of the delayed complications. In order to evaluate this specific problem following PPH, we reviewed our data with special reference to potential predictive factors or stenotic events.

Methods

A retrospective analysis of 554 consecutive patients that underwent PPH from July 2000 to December 2004 was performed. Only patients with follow-up check were evaluated; therefore 65 patients (11.7%) Hwere lost to follow-up, and the analysis therefore includes 489 patients with a mean follow-up of 324 days (± 18 days). For statistical analysis, the groups with and without stenosis were evaluated using the chi-square test; using the Kaplan-Meier statistic, the actuarial incidence for rectal stenosis was plotted.

Results

Rectal stenosis was observed in 12 patients (2.5%) in whom the median time to stenosis was 125 (89 ∼ 134) days. All patients complained of obstructive defecation and underwent strictureplasty with electrocautery or balloon dilation through colonoscopy. A statistical analysis revealed that two factors were significantly more prevalent among patients with stenosis: prior sclerosis therapy for hemorrhoids (P = 0.02) and severe postoperative pain (P = 0.003). Other factors, such as gender (P = 0.32), prior surgery for hemorrhoids (P = 0.11), histological evidence of squamous skin (P = 0.77) or revision (P = 0.53) showed no significance.

Conclusions

Rectal stenosis is an uncommon event after PPH. Early stenosis will occur within the first 4 months after surgery. In most cases, the stenosis can be cured through colonoscopy surgery. Predictive factors for stenosis are previous sclerosis therapy for hemorrhoids and severe postoperative pain.

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Authors and Affiliations

  1. Department of General Surgery, Zhongshan Hospital, Fudan University Medical Center, Shanghai, 200032, People’s Republic of China

    Liqin Yao MD, Yunshi Zhong MD, Jianmin Xu MD, PhD, Meidong Xu MD, PhD & Pinghong Zhou MD, PhD

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  1. Liqin Yao MD
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  2. Yunshi Zhong MD
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  3. Jianmin Xu MD, PhD
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  4. Meidong Xu MD, PhD
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  5. Pinghong Zhou MD, PhD
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Correspondence to Yunshi Zhong MD.

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Yao, L., Zhong, Y., Xu, J. et al. Rectal Stenosis after Procedures for Prolapse and Hemorrhoids (PPH)—A Report from China. World J. Surg. 30, 1311–1315 (2006). https://doi.org/10.1007/s00268-005-0484-0

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  • DOI: https://doi.org/10.1007/s00268-005-0484-0

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