Stapled hemorrhoidopexy. A single-center study on over 600 patients with long term follow-up

Abstract

OBJECTIVE; The aim of this study is to evaluate the results of patients treated by stapler hemorrhoidopexy for hemorrhoidal disease with a long term foloow up.

MATERIAL AND METHOD: Patients who were operated with stapled hemorrhoidopexy (SH) technique between 01/01/2009 and 01/01/2019 in the general surgery department were included. Patients with stage 2 and stage 3 hemorrhoidal disease included. All patients were operated by the same surgeon using a 33-mm circular PPH stapler. All patients were evaluated on the 7 th day with physical examination, at the second month with physical exam and flexible rectoscopy and at one year with physical examination or telephone call and then with follow up exams if they had symptoms.

RESULTS: 646 patients were included. 581 of them were discharged on the same day of the operation. At 1 week after surgery,78 patients (12 %) reported urgency and occasional gas leakage, and 18 patients (3%) reported liquid leakage. 68 patients ( 11%) developed grade 3 or 4 recurrence 38 (6 %) of these patients were treated with Milligan Morgan hemorroidectomy. 19 patients with bleeding were treated with band ligation . Fourty-five patients (7%) required drug therapy for treating hemorrhoidal bleeding. 42 patients developed anal fissure and three patients had anal stenosis.

CONCLUSIONS: SH provides high patient comfort and short hospital stay and is a good surgical alternative providing a low recurrence rate in the long run . This single center study with a long follow up period provides a contribution to literature.