Document Detail

Reinterventions for specific technique-related complications of stapled haemorrhoidopexy (SH): a critical appraisal.
MedLine Citation:
PMID:  18766410     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: Stapled haemorrhoidopexy (SH) is an attractive alternative to conventional haemorrhoidectomy (CH) because of reduced pain and earlier return to normal activities. However, complication rates are as high as 31%. Although some complications are similar to CH, most are specifically technique-related. In this prospective audit, we report our experience with the management of some of these complications. METHODS: Data on patients undergoing SH at our unit or referred to us are prospectively entered in a database. The onset or duration of specific SH-related complications as well as reinterventions for failed or complicated SH was recorded. RESULTS: From 1/03 to 10/07, 110 patients underwent SH, while 17 patients were referred after complicated/failed SH. Overall early and late complication rates after SH were 12.7% and 27.2%, respectively. Overall reintervention rate was 9.1%. Among the referred SH-group, one patient underwent Hartmann's procedure because of rectal perforation. The remaining 16 patients experienced at least one of the following: recurrence, urgency, frequency, severe persistent anal pain, colicky abdominal pain, anal fissure and stenosis. Four patients underwent CH with regular postoperative recovery. Two patients underwent exploration under anaesthesia because of persisting pain. One patient underwent anoplasty. CONCLUSIONS: SH presents unusual and challenging complications. Abuses should be minimized and longer-term studies are needed to further clarify its role.
Pierpaolo Sileri; Vito Maria Stolfi; Luana Franceschilli; Federico Perrone; Lodovico Patrizi; Achille Lucio Gaspari
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2008-09-03
Journal Detail:
Title:  Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract     Volume:  12     ISSN:  1873-4626     ISO Abbreviation:  J. Gastrointest. Surg.     Publication Date:  2008 Nov 
Date Detail:
Created Date:  2008-10-22     Completed Date:  2009-02-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9706084     Medline TA:  J Gastrointest Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1866-72; discussion 1872-3     Citation Subset:  IM    
Department of Surgery, University of Rome Tor Vergata, Rome, Italy.
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MeSH Terms
Cohort Studies
Digestive System Surgical Procedures / adverse effects*,  methods
Follow-Up Studies
Hemorrhoids / complications,  surgery*
Length of Stay
Middle Aged
Pain Measurement
Pain, Postoperative / physiopathology
Postoperative Complications / epidemiology
Proctoscopy / adverse effects*,  methods
Reoperation / statistics & numerical data
Retrospective Studies
Risk Assessment
Surgical Procedures, Minimally Invasive / instrumentation,  methods
Young Adult

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