Abstract
In this study we evaluated the results of stapled hemorrhoidopexy considering the histological features of the resected tissue obtained after the intervention, the staple line height and the improvement of the quality of life after the treatment. From January 2003 to December 2006, 72 patients with symptomatic grade 3 and 4 hemorrhoid that underwent stapled hemorrhoidopexy in our clinic were enroled in the study. Preoperative, intraoperative and postoperative characteristics of the patients were evaluated, including demographics, staple line height, specimen histology, complications, recurrence, day to return to work, quality of life (QoL) score and use of analgesics. Staple line height was always above 2.5 cm from the dentate line. Smooth muscle fibers were observed in 97.2%. The complication rate was 18%. Bleeding was observed in 5.5%. Fecal urgency was referred in 6.9%. Recurrence rate was 6.9%. Mean follow-up was 68 months. Hemorrhoidopexy is safe and effective but extreme attention must be paid to some critical details. We consider the placement of the purse string suture as a critical factor in the outcome of the patients. We find that some amount of the muscle fibers would invariably be involved in the resected specimen, without any significant impact in the clinical outcome or in the quality of life improvement.
Similar content being viewed by others
References
Sutherland LM, Burchard AK, Matsuda K, Sweeney JL, Bokey EL, CHilds PA, Roberts AK, Waxman BP, Maddern GJ (2002) A systematic review of stapled hemorrhoidectomy. Arch Surg 137:1395–1406
Mehigan BJ, Monson JRT, Hartley JE (2000) Stapling procedure for hemorrhoids versus Milligan–Morgan hemorrhoidectomy: randomised controlled trial. Lancet 355:782–785
Ravo B, Amato A, Bianco V, Boccasanta P, Bottini C, Carriero A, Milito G, Dodi G, Ma scagni D, Orsini S, Pietroletti R, Ripetti V, Tagariello GB (2002) Complications after stapled haemorroidectomy: can they be prevented? Tech Coloproctol 6:83–88
Wong LY, Jiang JK, Chang SC, Lin JK (2003) Rectal perforation: a life-threatening complication of stapled hemorrhoidectomy. Dis Colon Rectum 46:116–117
Eypasch E, Williams J, Wood-Dauphinee S, Ure BM, Schmülling C, Neugebauer E, Troidl H (1995) Gastrointestinal quality of life index: development, validation and application of a new instrument. Br J Surg 82:216–222
Longo A (1998) Treatment of hemorrhoidal disease by reduction of mucosa and haemorrhoidal prolapse with a circular suturing device: a new procedure. In: Proceedings of the sixth world congress of endoscopic surgery, Monduzzi Editore, Bologna, p.777–784
Fazio VW (2000) Early promise of stapling technique for haemorroidectomy. Lancet 355:768–769
Roswell M, Bello M, Hemingway DM (2000) Circumferential mucosectomy (stapled haemorroidectomy) versus conventional haemorroidectomy: randomised controlled trial. Lancet 355:779–781
Seow-Cohen F (2001) Stapled haemorroidectomy: pain or gain. Br J Surg 88:1–3
Ng KH, Ho KS, Ooi BS, Tang CL, Eu KW (2006) Experience of 3711 stapled haemorroidectomy operations. Br. J.Surg 93:226–230
Corman ML, Gravié JF, Hager T, Loudon MA, Mascagni D, Nystrom PO, Seow-Choen F, Abcarian H, Marcello P, Weiss E (2003) Longo A: Stapled haemorroidipexy: a consensus position paper by an international working party-indications, contra-indications and technique. Colorectal dis 5:304–310
Kam MH, Mathur P, Peng XH, Seow-Choen Chew WC, Kumarasinghe MP (2005) Correlation of histology with anorectal function following stapled hemorrhoidectomy. Dis Colon Rectum 48:1437–1441
Ohana G, Myslovaty B, Ariche A, Dreznik Z, Koren R, Rath-Wolfson L (2007) World J Surg 31:1336–1342
Plocek MD, Kondylis LA, Duhan-Floyd N, Reilly JC, Geisler DP, Kondylis PD (2006) Dis Colon Rectum 49:1905–1909
Correa-Rovelo JM, Tellez O, Obregon L, Duque-Lopez X, Miranda-Gomez A, Pichardo-Bahena R, Mendez M, Moran S (2003) Prospective study of factors affecting postoperative pain and symptoms persistence after stapled rectal mucosectomy for hemorrhoids: a need for preservation of squamous epithelium. Dis Colon Rectum 46:955–962
Raahave D, Jepsen LV, Pedersen IK (2008) Primary and repeated stapled hemorrhoidopexy for prolapsing hemorrhoids: follow up to five years. Dis Colon Rectum 3:334–341
Gagliardi G, Pescatori M, Altomare DF et al (2008) Results, outcome predictors and complications after stapled transanal rectal resection for obstructed defecation. Dis Colon Rectum 2:186–195
Conflict of interest
The authors declare that they have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Calomino, N., Martellucci, J., Fontani, A. et al. Care with regard to details improves the outcome of Longo mucoprolapsectomy: long term follow up. Updates Surg 63, 151–154 (2011). https://doi.org/10.1007/s13304-011-0077-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s13304-011-0077-4