The Longo technique, described in 1993, is proposed for the treatment of hemorrhoidal disease. The stapled hemorrhoidopexy has been introduced as an alternative to conventional hemorrhoidectomy. Despite a clear perioperative advantage regarding pain and patient comfort, the stapled hemorrhoidopexy may be followed by unusual postoperative complications. Complications may occur after stapled hemorrhoidopexy, some are particularly serious, especially bleeding and sepsis. Since 2002 more than 130 articles have been published reporting complications during and after stapled hemorrhoidopexy.
Complications were classified as being either early or late if they occurred within 7 days of the operation. Those occurring after 7 days were considered to be late.
The most common complication is early bleeding. Severe postoperative pain could be caused by dehiscence of the anastomosis or due to the fact that the anastomosis is too near to the linea dentata.
A lot of long-term complications have been described. Most of them are related to either an incorrect indication for surgery or technical errors. Severe complications leading to death have been described but are rare. The persistent anal pain after stapled hemorrhoidopexy has in the most cases the objective findings of the staple line hardened and fixed to muscular layer beyond. Irreversible urge incontinence due to lesions of the sphincter muscle or a diminished rectal capacity due to resection of too much mucosa is quite common complication if the procedure is not performed properly. Rectovaginal fistulas and anastomotic diverticula are very rare but possible.
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