Davide Lomanto1, Avinash N Katara. 1. Minimally Invasive Surgical Centre, Department of General Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. surdl@nus.edu.sg
Abstract
OBJECTIVE: In prolapsed haemorrhoids, there is a permanent outward displacement of the mucosa of the anal canal, often involving the rectal mucosa. On this background, Longo set up a technique in 1998 to reduce haemorrhoidal prolapse, using a circular stapler. The aim of this study is to report our 7 years of experience on patients treated using this new surgical technique for haemorrhoids. METHODS: Between October 1998 and June 2005, 496 patients were treated by stapled haemorrhoidopexy. We analysed data from 300 of these patients in whom follow-up was longer than 12 months. RESULTS: The duration of the procedure ranged from 12 to 45 minutes. In 184 patients (37%), haemostatic stitches of the suture line were necessary after firing the stapler. Pain score (visual analogue scale, 1-10) after 24 hours ranged from 2 to 4 and after 5 days from 1 to 3. The average length of hospital stay was 2.3 days. Long-term results showed that only 9% of patients required further treatment after long follow-up, while 10.1% complained of some discomfort or residual symptoms in the perianal region. CONCLUSION: Our short- and long-term results show that stapled haemorrhoidopexy for haemorrhoids is a safe procedure with less pain and lower complication rate compared to conventional haemorrhoidectomy.
OBJECTIVE: In prolapsed haemorrhoids, there is a permanent outward displacement of the mucosa of the anal canal, often involving the rectal mucosa. On this background, Longo set up a technique in 1998 to reduce haemorrhoidal prolapse, using a circular stapler. The aim of this study is to report our 7 years of experience on patients treated using this new surgical technique for haemorrhoids. METHODS: Between October 1998 and June 2005, 496 patients were treated by stapled haemorrhoidopexy. We analysed data from 300 of these patients in whom follow-up was longer than 12 months. RESULTS: The duration of the procedure ranged from 12 to 45 minutes. In 184 patients (37%), haemostatic stitches of the suture line were necessary after firing the stapler. Pain score (visual analogue scale, 1-10) after 24 hours ranged from 2 to 4 and after 5 days from 1 to 3. The average length of hospital stay was 2.3 days. Long-term results showed that only 9% of patients required further treatment after long follow-up, while 10.1% complained of some discomfort or residual symptoms in the perianal region. CONCLUSION: Our short- and long-term results show that stapled haemorrhoidopexy for haemorrhoids is a safe procedure with less pain and lower complication rate compared to conventional haemorrhoidectomy.