Stapler Procedure for Anal Prolapse and Hemorrhoids: Long-term Results
Authors:
I. Pospíšil; V. Motyčka
Authors‘ workplace:
Chirurgická klinika LF UK a FN Hradec Králové, přednosta: prof. MUDr. Alexander Ferko, CSc.
Published in:
Rozhl. Chir., 2010, roč. 89, č. 4, s. 256-260.
Category:
Monothematic special - Original
Overview
Introduction:
The surgical treatment of internal hemorrhoids and anal canal prolapse using stapler technique was introduced to clinical practice by Longo, as soon as in 1993. Few years later, Czech surgeons became familiar with this technique, and even it is being performed in many surgical departments of our country at the present time. At the Dept. of Surgery, Teaching Hospital Hradec Králové, this surgical method has been carried out since 1999.
The aim of this work:
To analyze the long-term results of the Longo’s operation. This study has been based on the retrospective documentation analysis complemented by a questionnaire-survey.
Methodology:
It is the retrospective documentation study complemented by a questionnaire-survey. The patients received a questionnaire asking questions regarding their subjective feelings and opinions on surgical treatment, as well as on recent status of the illness. Furthermore, the medical documentation was analysed with particular attention to the post-operative period with regard to complications, analgetic therapy need, operation-time, length of the hospital stay and recovery time.
Results:
Since 1999, the authors have used stapler technique in internal hemorrhoids operations in 71 patients. From this number 65 patients who were operated on at least one year before the follow-up analysis was performed were included into the study. 51 patients completed and gave back the questionnaire. Average following time was 5.5 years. 92 percent of the patients are very satisfied with the Longo’s operation. Low rate of complications, small postoperative pain and early recovery are the basic merits of the hemorrhoids operation with use of stapler technique.
Conclusion:
We think of Longo’s operation in indicated cases as safe and suitable for the hemorrhoids therapy.
Key words:
Longo’s operation – hemorrhoids – anal prolapse
Sources
1. Longo, A. Treatment of haemorrhoids dinase by reduction of mucosa and haemorrhoidal prolapse with a circular-suturing device: a new procedure. Proceedings of the Sixth World Congress of Endoscopic Surgery, Rome, Italy, 3-6 June, 1998, s. 777–784.
2. Demirbas, S., Aktas, O., Ogun, I., et al. Hemorrhoidectomy by using circular stapler in grade 3-4 hemorrhoids. T. Klin. J. Med. Sci., 22, 2002, č. 1, s. 36–41.
3. Král, J. Longova metoda operace hemoroidů a prolapsu sliznice anorekta (PPH) – zkušenosti 8 let. Rozhl. Chir., 86, 2007, č. 12, s. 678–679.
4. Jayaraman, S., Colquhoun, P. H., Malthaner, R. A. Stapled versus conventional surgery for hemorrhoids. Cochrane Database Syst. Rev., 2006, č. 4, Art. No.: CD005393.
5. Giordano, P., Gravante, G. Long-term outcomes of stapled hemorrhoidopexy vs conventional hemorrhoidectomy. Arch. Surg., 144, 2009, č.3, s. 266–272.
6. Martinsons, A., Narbuts, Z., Brunenieks, I., et al. A comparison of quality of life and postoperative results from combined PPH and conventional hemorrhoidectomy in different cases of hemorrhoidal disease. Colorectal Dis., 9, 2007, č. 5, s. 423–429.
7. Candela, G., Varriale, S., Di Libero, L., et al. The gold standard in the treatment of hemorrhoidal disease. Milligan-Morgan hemorrhoidectomy vs Longo mucoprolapsectomy: comparing techniques. Minerva Chir., 62, 2007, č. 3, s. 151–159.
8. van de Stadt, J., D‘Hoore, A., Duinslaeger, M., et al. Long-term results after excision hemorrhoidectomy versus stapled hemorrhoidopexy for prolapsing hemorrhoids: a Belgian prospective randomized trial. Acta Chir. Belg., 105, 2005, č. 1, s. 44–52.
9. Lomanto, D., Katara, A. N. Stapled hemorrhoidopexy for prolapsed hemorrhoids: short-and long-term experience. Asian J. Surg., 30, 2007, č. 1, s. 29–33.
10. Scotto di Carlo, E., Medolla, A., Savino, F., et al. Treatment of mucous and hemorrhoidal prolapse according to Longo: personal experience. Chir. Ital., 59, 2007, č. 3, s. 347–353.
11. Štukavec, J., Horák, L. Komplikace operace podle Longa – okluze rekta. Rozhl. Chir., 85, 2006, č. 10, s. 517–519.
12. van Wensen, R. J. A., van Leuken, M. H., Bosscha, K. Pelvic sepsis after hemorrhoidopexy. World J. Gastroenterol., 14, 2008, č. 38, s. 5924–5926.
13. Molloy, R. G., Kingsmore, D. Life threatening pelvic sepsis after stapled hemorrhoidectomy. Lancet, 355, 2000, č. 9206, s. 810.
14. Pessaux, P., Lermite, E., Tuech, J. J., et al. Pelvic sepsis after stapled hemorrhoidectomy. J. Am. Coll. Surg., 199, 2004, č. 5, s. 824–825.
15. Maw, A., Eu, K. W., Seow-Choen, F. Retroperitoneal sepsis complicating stapled hemorrhoidectomy: report of a case and review of the literature. Dis. Colon Rectum, 45, 2002, č. 6, s. 116–117.
16. Wong, L. Y., Jiang, J. K., Chang, S. C., et al. Rectal perforation: a life- threatening complication of stapled hemorrhoidectomy: report of a case. Dis. Colon Rectum, 46, 2003, č. 1, s. 116–117.
17. Herold, A., Kirsch, J. J. Painafter stapled hemorrhoidectomy. Lancet, 356, 2000, č. 9248, s. 2187.
18. Pescatori, M. Stapled rectal prolapsectomy. Dis. Colon Rectum, 43, 2000, č. 6, s. 876–878.
19. Angelone, G., Giardiello, C., Prota, C. Stapled hemorrhoidopexy. Complications and 2-year follow up. Chir. Ital., 58, 2006, č. 6, s. 753–750.
20. Gravié, J. F., Lehur, P. A., Huten, N., et al. Stapled hemorrhoidopexy versus Milligan-Morgan hemorrhoidectomy: a prospective, randomized, multicenter trial with 2-year postoperative follow up. Ann. Surg., 242, 2005, č. 1, s. 29–35.
21. Stolfi, V. M., Sileri, P., Micossi, C. et al. Treatment of hemorrhoids in day surgery: stapled hemorrhoidopexy vs Milligan-Morgan hemorrhoidectomy. J. Gastrointest. Surg., 12, 2008, č. 5, s. 795–801.
22. Tjandra, J. J., Chan, M. K. Systematic review on the procedure for prolapse and hemorrhoids (stapled hemorrhoidopexy). Dis. Colon Rectum, 51, 2007, č. 6, s. 253–254.
Labels
Surgery Orthopaedics Trauma surgeryArticle was published in
Perspectives in Surgery
2010 Issue 4
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