ABSTRACT
Aim of this study was to evaluate early and late outcome of patients with hemorrhoidal disease to whom stapled hemorrhoidopexy was performed.
Patients with grade 3 – 4 hemorrhoidal disease to whom stapled hemorrhoidopexy was performed between February 2006 and October 2007 were prospectively evaluated for initial complaint, duration of complaint, co-morbid anal disease and post operative complaints. Operation was performed with the technique of Longo. Patients were invited for routine follow-up at 1, 2 and 12 months after operation. Visual analog scale (VAS) was used for assesment of pain.
Of the 50 cases 38 were men and 12 were women with a mean age of 39.3 (range: 26 - 67) and range of complaint duration was between 3 to 36 months. Mean operation duration was 27 minutes (10 -45 minutes). Lateral internal sphincterotomy was performed to 5 patients with comorbid anal fissure and 2 patients' thrombosed hemorrhoids were excised. All patients received IV NSAID (Tenoksikam) postoperatively. Mean VAS score was 1.6 (1-6). Mean length of hospital stay was 28.5 hours (24-72). 6 patients required re-operation: 3 patient with late bleeding (post-operative 7-10days) required suture ligation, 1 patient with persistant pain required examination under anesthesia, 1 patient with external thrombosed hemorrhoid required ligasure hemorrhoidectomy and 1 patient with intersphincteric abcess, 4 months after the operation required drainage. At the end of 1 year follow up none of the patients had active complaints.
Stapled Hemorrhoidopexy is an easily performed method with acceptable pain level and short healing process however, it may have serious post - operative complications, it is expensive and should be performed to selected cases.