[Stapler hemorrhoidectomy versus conventional procedures - a clinical study]

Abstract

Stapled Hemorrhoidectomy is when correctly indicated an easy feasible operative procedure for prolapsing internal hemorrhoids with or without a mucosal prolapse offering benefits to the patient. From July 1998 to October 2000 we treated 152 patients with a mean age of 52 (24-91) years for hemorrhoids within this study. We compared 72 patients, treated with stapled hemorrhoidectomy according to Koblandin-Longo with 80 patients who underwent a "conventional" reconstructive operation (Parks or Fansler-Arnold). All resected material was histopathologically examined. With stapler hemorrhoidectomy we found on average shorter operation times (22 vs. 53 min, p < 0.01), shorter hospitalisation (3 vs. 6.1 d, p < 0.01), significantly less postoperative pain (VAS 0-10: 1.83 vs. 3.70, p < 0.01) and fewer cumulative requests for analgesia by the patients (0.92 vs. 3.11 single doses, p < 0.01). The complication rate was 4 % in the stapler group and 11 % in the conventional group. Stapled hemorrhoidectomy was carried out only in patients with 3 degrees hemorrhoids with or without mucosal prolapse. The conventional group consisted of patients with 3 degrees prolapsing or 4 degrees fixated external hemorrhoids. Although very promising results are actually described with stapler hemorrhoidectomy, the established conventional reconstructive operations should be continued until long-term results are published.