Abstract
We report an incident of complete stapled closure of the rectal lumen following stapled hemorrhoidopexy. A patient with symptomatic prolapsing hemorrhoids underwent a stapled hemorrhoidopexy as a day-case procedure. After application of the pursestring suture and firing of the dedicated stapler the rectal lumen was found to have been completely obliterated. Endoscopic assessment using a flexible sigmoidoscope confirmed the absence of a rectal lumen. The patient was woken up and a gastrograffin enema performed. Contrast was injected under high pressure into the rectal lumen and a small defect in the mid point of the staple line was revealed. A fine guidewire was passed and endoscopic balloon dilatation achieved. This complication could have had catastrophic consequences and potentially required major surgical intervention. Although unlikely to occur, we believe that surgeons should be aware of this possible problem and a radiologic/endoscopic approach should be considered before more aggressive surgical intervention is undertaken.
References
Beattie GC, McAdam TK, McIntosh SA, Loudon MA. Day case stapled haemorrhoidopexy for prolapsing haemorrhoids. Colorectal Dis 2006;8:56–61.
Kraemer M, Parulava T, Roblick M, Duschka L, Muller-Lobeck H. Prospective, randomized study: proximate PPH stapler vs LigaSure for hemorrhoidal surgery. Dis Colon Rectum 2005;48:1517–22.
Mlakar B, Kosorok P. Complications and results after stapled haemorrhoidopexy as a day surgical procedure. Tech Coloproctol 2003;7:164–7.
Corman ML, Gravie JF, Hager T, et al. Stapled haemorrhoidopexy: a consensus position paper by an international working party: indications, contra-indications and technique. Colorectal Dis 2003;5:304–10.
Gravie JF, Lehur PA, Huten N, et al. Stapled hemorrhoidopexy versus Milligan-Morgan hemorrhoidectomy: a prospective, randomized, multicenter trial with 2-year postoperative follow up. Ann Surg 2005;242:29–35.
Nisar PJ, Acheson AG, Neal KR, Scholefield JH. Stapled hemorrhoidopexy compared with conventional hemorrhoidectomy: systematic review of randomized, controlled trials. Dis Colon Rectum 2004;47:1837–45.
Jongen J, Bock JU, Peleikis HG, Eberstein A, Pfister K. Complications and reoperations in stapled anopexy: learning by doing. Int J Colorectal Dis 2006;21:166–71.
Wong LY, Jiang JK, Chang SC, Lin JK. Rectal perforation: a life-threatening complication of stapled hemorrhoidectomy: report of a case. Dis Colon Rectum 2003;46:116–7.
Mongardini M, Custureri F, Schillaci F, et al. Rectal stenosis after stapler hemorrhoidopexy. G Chir 2005;26:275–7.
Oughriss M, Yver R, Faucheron JL. Complications of stapled haemorrhoidectomy: a French multicentric study. Gastroenterol Clin Biol 2005;29:429–33.
Longo A. Treatment of haemorrhoidal disease by reduction of mucosa and haemorrhoidal prolapse with a circular stapling device. In: Proceedings of the 6th World Congress of Endoscopic Surgery. Bologna: Monduzzi Editore, 1998:777–84.
Cipriani S, Pescatori M. Acute rectal obstruction after PPH stapled haemorrhoidectomy. Colorectal Dis 2002;4:367–70.
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Giordano, P., Bradley, B.M. & Peiris, L. Obliteration of the Rectal Lumen After Stapled Hemorrhoidopexy: Report of a Case. Dis Colon Rectum 51, 1574–1576 (2008). https://doi.org/10.1007/s10350-008-9367-4
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DOI: https://doi.org/10.1007/s10350-008-9367-4