PURPOSE: The purpose of the study was to analyse the outcomes of all patients requiring a reoperation after an initial circular stapled haemorrhoidopexy (SH) for prolapsing haemorrhoids. METHODS: Data of all patients undergoing a circular SH from 1998 thru 2007 available in a prospectively collected database were reviewed, and all patients who had reoperations were studied. RESULTS: During the study period, 1,233 patients (551 females, median age 52 years) underwent a circular SH. Complete follow-up was available in all patients (median follow-up 7 months, range 0.5-100); 127 patients (10.3%) required one or more reoperations. Early reoperations (<30 days) were necessary in 47 patients (3.8%), and 45 (3.6%) were stapler-related complications. Late reoperations (>30 days) were performed in 84 patients (6.8%) and 57 (4.6%) were stapler-related. A learning curve was observed with significant reduction of early (<30 days) and late (>30 days) reoperation rate with time. CONCLUSIONS: Reoperations after SH are necessary in about 10% of the patients. The majority of the reoperations are due to either complications arising from circular SH, recurrent/persistent haemorrhoidal symptoms or other anorectal issues not addressed by the circular SH procedure (3.8% early; 6.8% late). Circular SH appears to be an effective procedure for symptomatic haemorrhoidal disease; however, training and learning curve issues should be addressed to minimise treatment failures.
PURPOSE: The purpose of the study was to analyse the outcomes of all patients requiring a reoperation after an initial circular stapled haemorrhoidopexy (SH) for prolapsing haemorrhoids. METHODS: Data of all patients undergoing a circular SH from 1998 thru 2007 available in a prospectively collected database were reviewed, and all patients who had reoperations were studied. RESULTS: During the study period, 1,233 patients (551 females, median age 52 years) underwent a circular SH. Complete follow-up was available in all patients (median follow-up 7 months, range 0.5-100); 127 patients (10.3%) required one or more reoperations. Early reoperations (<30 days) were necessary in 47 patients (3.8%), and 45 (3.6%) were stapler-related complications. Late reoperations (>30 days) were performed in 84 patients (6.8%) and 57 (4.6%) were stapler-related. A learning curve was observed with significant reduction of early (<30 days) and late (>30 days) reoperation rate with time. CONCLUSIONS: Reoperations after SH are necessary in about 10% of the patients. The majority of the reoperations are due to either complications arising from circular SH, recurrent/persistent haemorrhoidal symptoms or other anorectal issues not addressed by the circular SH procedure (3.8% early; 6.8% late). Circular SH appears to be an effective procedure for symptomatic haemorrhoidal disease; however, training and learning curve issues should be addressed to minimise treatment failures.
Authors: Marc A Singer; José R Cintron; James W Fleshman; Vivek Chaudhry; Elisa H Birnbaum; Thomas E Read; James S Spitz; Herand Abcarian Journal: Dis Colon Rectum Date: 2002-03 Impact factor: 4.585
Authors: M B Tempel; E G Pearson; M Page; D Pollock; K Gilmore-Lynch; W Peche; B Sklow; M Snyder Journal: Tech Coloproctol Date: 2013-12-19 Impact factor: 3.781