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. 2014 Mar;9(1):18-23.
doi: 10.5114/wiitm.2011.35784. Epub 2013 Nov 26.

Long-term outcomes of stapled hemorrhoidopexy

Maciej Michalik  1 , Maciej Pawlak  1 , Maciej Bobowicz  2 , Mieczysław Witzling  1
Affiliations

Long-term outcomes of stapled hemorrhoidopexy

Maciej Michalik et al. Wideochir Inne Tech Maloinwazyjne. 2014 Mar.

Abstract

Introduction: Hemorrhoidal disease is one of the commonest anorectal disorders worldwide. Stapled hemorrhoidopexy (SH) is a treatment modality associated with low postoperative pain and early mobilization.

Aim: To assess long-term outcomes after SH.

Material and methods: All 326 patients who underwent SH in 1999-2003 were invited by mail to participate. For each patient we analyzed their medical records, and conducted a questionnaire survey and a digital rectal examination.

Results: Only 91 patients attended the final examination and the mean ± SD follow-up time was 8.7 ±1.2 years. Recurrences were diagnosed in one third of the 91 subjects. There were correlations between recurrences and: the duration of disease (p = 0.047); female gender (p = 0.037); and childbirth (vaginal delivery) (p = 0.026). Sixty-seven patients (73.6%) were satisfied with the outcomes. In the group of dissatisfied patients symptoms such as pain (p = 0.0001), burning (p = 0.0002) and itching (p = 0.014) were most common. Long-term outcomes were good with 75% and 88% reductions in pain sensation and severe and moderate hemorrhoidal bleeding. Pruritus, burning and discomfort resolved in more than 50% of patients. Flatus incontinence, fecal incontinence, or soiling occurred in 21%, 11%, and 32% of patients.

Conclusions: Long-term results of stapled hemorrhoidopexy are satisfactory in most patients. The 36% recurrence rate correlates with the degree of hemorrhoidal prolapse before the operation, duration of the disease, female gender, and previous vaginal delivery.

Keywords: anorectal surgery; hemorrhoids; stapled hemorrhoidopexy.

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Figures

Figure 1
Figure 1
Distribution of recurrences over time
Figure 2
Figure 2
Number of recurrences in relation to pre-operative hemorrhoid prolapse level
See this image and copyright information in PMC

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