INTRODUCTION: Stapled haemorrhoidectomy according to Longo for treating reducible anal and mucosal prolapse appears to be very simple technically. In order to investigate the feasibility and to delineate the value of this procedure it was compared to standard open haemorrhoidectomy according to Milligan-Morgan in a prospective study. METHOD: In 1998 and 1999, 300 patients with third-degree haemorrhoids were operated on either with a Milligan-Morgan or a Longo technique. Intraoperative and postoperative performance--complications, length of surgery, consumption of analgetics, hospital stay, return to work--were evaluated. Follow-up was 1, 3 and 6 months. RESULTS: Length of surgery for both types of operation was the same. In comparison with the conventional open excision, patients with a stapled haemorrhoidectomy required considerably less analgetics. Hospital stay was shorter and return to work quicker and there were fewer morphological residues, e.g. skin tags. However, the costs of the procedure were considerably higher because of the disposable instrument. CONCLUSION: This new surgical procedure of supra-anodermal resection according to Longo offers advantages in the repair of prolapsing haemorrhoidal disease. Despite its primary simplicity, in our opinion the surgeon has to have colorectal, especially proctologic, experience. Although costs are significantly higher, this procedure might replace conventional techniques in many cases with prolapsing haemorrhoids.
INTRODUCTION: Stapled haemorrhoidectomy according to Longo for treating reducible anal and mucosal prolapse appears to be very simple technically. In order to investigate the feasibility and to delineate the value of this procedure it was compared to standard open haemorrhoidectomy according to Milligan-Morgan in a prospective study. METHOD: In 1998 and 1999, 300 patients with third-degree haemorrhoids were operated on either with a Milligan-Morgan or a Longo technique. Intraoperative and postoperative performance--complications, length of surgery, consumption of analgetics, hospital stay, return to work--were evaluated. Follow-up was 1, 3 and 6 months. RESULTS: Length of surgery for both types of operation was the same. In comparison with the conventional open excision, patients with a stapled haemorrhoidectomy required considerably less analgetics. Hospital stay was shorter and return to work quicker and there were fewer morphological residues, e.g. skin tags. However, the costs of the procedure were considerably higher because of the disposable instrument. CONCLUSION: This new surgical procedure of supra-anodermal resection according to Longo offers advantages in the repair of prolapsing haemorrhoidal disease. Despite its primary simplicity, in our opinion the surgeon has to have colorectal, especially proctologic, experience. Although costs are significantly higher, this procedure might replace conventional techniques in many cases with prolapsing haemorrhoids.
Authors: Angelita Habr-Gama; Afonso H S e Sous; José Manuel Correia Roveló; Jayme Vital Santos Souza; Fernando Benício; Francisco S P Regadas; Cláudio Wainstein; Túlio Marcos Rodrigues da Cunha; Carlos Frederico S Marques; Renato Bonardi; José Reinan Ramos; Luiz Cláudio Pandini; Desidério Kiss Journal: J Gastrointest Surg Date: 2003 Sep-Oct Impact factor: 3.452