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Long-term results after stapled hemorrhoidopexy: a survey study with mean follow-up of 12 years

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A Correction to this article was published on 01 September 2018

This article has been updated

Abstract

Background

Hemorrhoidal prolapse is a common benign disease. The introduction of circular-stapled hemorrhoidopexy as an alternative to the conventional hemorrhoidectomy led to a new spectrum of postoperative outcomes and complications. The aim of the present study was to evaluate long-term results after stapled hemorrhoidopexy.

Methods

All the patients who had stapled hemorrhoidopexy using a PPH03 stapler, from January 2003 to December 2005, were retrospectively collected in a dedicated database. Between March and May 2016, all the patients were asked by phone to complete a questionnaire. The study evaluated anatomical recurrence, symptom recurrence and frequency, and satisfaction after surgery. The postoperative complications recorded were hemorrhage, hematoma, urinary retention, anastomotic stenosis, persistent anal pain, tenesmus, and impaired anal continence evaluated also with the Faecal Incontinence Severity Index score.

Results

One hundred and ninety four patients were identified and 171 completed the questionnaire. The mean follow-up was 12 ± 0.8 years (range 11–13 years). Anatomical self-reported prolapse recurrence was 40.9% (n = 70). In 75.6% (n = 129) of patients, the severity and frequency of symptoms improved. The overall complication rate was 56.7% (n = 40) with a serious adverse event rate of 8.7% (n = 15). The overall tenesmus rate was 38.2% (n = 65) and the overall impaired continence rate was 39.1% (n = 67). Medical therapy was still required occasionally by 40.3% (n = 69) of the patients and 9.3% (n = 16) of the patients underwent surgery for recurrence. Patient satisfaction rate was good (≥ 3 on a scale of 1 to 5) in 81.2% (n = 139) of cases.

Conclusions

The study showed that stapled hemorrhoidopexy using the first-generation devices is safe and feasible but associated with a high recurrence and incontinence rate. More stringent selection criteria in association with the use of large volume devices can lead to better results in the future.

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Change history

  • 11 October 2018

    Unfortunately, the 7th author’s family name was incorrectly published in the original publication. The complete correct name should read as follows:

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Author information

Authors and Affiliations

  1. Proctological and Perineal Surgical Unit, Cisanello University Hospital, Via Paradisa 2, Pisa, Italy

    A. Sturiale, B. Fabiani, C. Menconi, D. Cafaro, F. Fusco & G. Naldini

  2. Colo-proctological Surgical Unit, S. Maria dei Battuti Hospital, Conegliano, Italy

    G. Bellio & M. Schiano di Visconte

Authors
  1. A. Sturiale
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  2. B. Fabiani
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  3. C. Menconi
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  4. D. Cafaro
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  5. F. Fusco
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  6. G. Bellio
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  7. M. Schiano di Visconte
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  8. G. Naldini
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Contributions

Gabriele Naldini, Alessandro Sturiale, and Bernardina Fabiani contribute to the conception and of the study and to the drawing up of the manuscript; Alessandro Sturiale Ferdinando Fusco, Michele Schiano di Visconte, Gabriele Bellio, and Danilo Cafaro contribute to the data acquisition, analysis, and interpretation; Alessandro Sturiale, Claudia Menconi, Bernardina Fabiani, and Gabriele Naldini contribute to the critical revision of the manuscript and to the approval of the version to be published.

Corresponding author

Correspondence to A. Sturiale.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

All the patients were detailed informed about the aim of the study at the beginning of the phone call and all of the participants answered “yes” to the question “Would you answer the questionnaire and join to this study”.

Additional information

The original version of this article was revised to update 7th author family name in the author group.

Appendix A: Questionnaire

Appendix A: Questionnaire

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Sturiale, A., Fabiani, B., Menconi, C. et al. Long-term results after stapled hemorrhoidopexy: a survey study with mean follow-up of 12 years. Tech Coloproctol 22, 689–696 (2018). https://doi.org/10.1007/s10151-018-1860-8

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  • DOI: https://doi.org/10.1007/s10151-018-1860-8

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