Documented Complications of Staple Hemorrhoidopexy: A Systematic Review

Porrett, Liesel; Porrett, Jemma K.; Ho, Yik‐Hong

doi:10.9738/intsurg-d-13-00173.1

Cited by 67 publications

(55 citation statements)

References 80 publications

(120 reference statements)

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“…Overall procedural complication rates of SH ranged from 2 to 68%. However, these complications may typically occur in about 16% of procedures [147,173,174].…”

Section: ; Grade Of Recommendation: B)mentioning

confidence: 99%

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Consensus statement of the Italian society of colorectal surgery (SICCR): management and treatment of hemorrhoidal disease

et al. 2020

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Hemorrhoidal disease (HD) is the most common proctological disease in the Western countries. However, its real prevalence is underestimated due to the frequent self-medication. The aim of this consensus statement is to provide evidence-based data to allow an individualized and appropriate management and treatment of HD. The strategy used to search for evidence was based on application of electronic sources such as MEDLINE, PubMed, Cochrane Review Library, CINAHL, and EMBASE. These guidelines are inclusive and not prescriptive. The recommendations were defined and graded based on the current levels of evidence and in accordance with the criteria adopted by American College of Chest Physicians. The recommendations were graded A, B, and C.

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“…Overall procedural complication rates of SH ranged from 2 to 68%. However, these complications may typically occur in about 16% of procedures [147,173,174].…”

Section: ; Grade Of Recommendation: B)mentioning

confidence: 99%

“…Early fecal urgency after SH has been reported, with incidence rates of 0-25%, and a median of 8% [173].…”

Section: ; Grade Of Recommendation: B)mentioning

confidence: 99%

Consensus statement of the Italian society of colorectal surgery (SICCR): management and treatment of hemorrhoidal disease

et al. 2020

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“…When the rectal mucosa enters the anal canal, at the pelvic floor, it is thrown into longitudinal folds, known as columns of Morgagni. These folds contain, in the underlining mucosa, the internal hemorrhoidal plexus which is made of sinusoids [5][6].…”

Section: Discussionmentioning

confidence: 99%

Complications of stapled hemorrhoidectomy

2020

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Background: Stapled hemorrhoidectomy (SH), a new approach to the treatment of hemorrhoids, removes a circumferential strip of mucosa about four centimeters above the dentate line. Immediate complications (first week) were: severe pain in all patients, bleeding, thrombosis, urinary retention, anastomotic Dehiscence, fissurePerineal intramural hematoma, and submucosal abscess The most common complication after 1 week was recurrence of hemorrhoids in of patients, severe pain, stenosis, fissure, bleeding, skin tag, thrombosis, papillary hypertrophy, fecal urgency, staples problems, gas flatus and fecal incontinence, intramural abscess, partial dehiscence, mucosal septum, and intussusceptions.

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“…Late complications included bleeding (0.2%-33%), anal strictures and stenosis (0%-15.6%), incontinence (0.1%-17.8%), and fecal urgency (0%-25%). 22 Sepsis was reported in 16 cases (0.1%) 22 and death associated with rectal perforation and sepsis in 4 cases (0.03%) using a PPH stapler. 23,24 The primary end point rate of intraoperative bleeding requiring intervention with the EEA stapler in the current study (41%) is consistent with prior publications and lower than that observed with the PPH stapler.…”

Section: Discussionmentioning

confidence: 99%

Prospective, Multicenter Randomized Controlled Trial Comparing Two Hemorrhoidopexy Staplers: The HEMOSTASIS Study

Marcet

Ferrara²,

Rivadeneira

et al. 2018

International Surgery

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The objective of this study was to compare two hemorrhoidopexy staplers (EEA versus PPH03). Stapled hemorrhoidopexy is a treatment option for patients with symptomatic internal hemorrhoids who have failed more conservative measures. However, staple line bleeding remains common. Recent improvements in stapler design have attempted to reduce intraoperative bleeding and the need for intervention. HEMOSTASIS is a prospective, multicenter, 1:1 randomized controlled trial. Twelve hospital centers in the United States enrolled participants between 18 and 85 years of age with symptomatic grades 2 to 3 internal hemorrhoids. The primary end point was intraoperative bleeding, defined as bleeding requiring intervention (e.g., placement of sutures, cauterization, or ligation to achieve hemostasis). Secondary end points included staple line location, postoperative pain, quality of life, operative time, length of hospital stay, adverse events, and complication rates. On the primary end point, the rates of intraoperative bleeding requiring intervention were 41.0% (32 of 78) with EEA and 70.4% (50 of 71) with PPH (P < 0.001). Treatment for active bleeding was required in 30.8% versus 57.7% (P < 0.001) in the EEA and PPH arms, respectively. There were no significant differences between groups in postoperative pain. Adverse events and perioperative complication rates were generally mild/moderate and were similar between groups: 74.1% (60 of 81) of patients in the EEA group reported at least one adverse event versus 80.9% (55 of 68) in the PPH group (P = 0.32). Intraoperative bleeding occurred less often after stapled hemorrhoidopexy with the EEA stapler compared with the PPH03 stapler. Intervention to achieve hemostasis was required less often with the EEA stapler.

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Documented Complications of Staple Hemorrhoidopexy: A Systematic Review

Cited by 67 publications

References 80 publications

Consensus statement of the Italian society of colorectal surgery (SICCR): management and treatment of hemorrhoidal disease

Consensus statement of the Italian society of colorectal surgery (SICCR): management and treatment of hemorrhoidal disease

Complications of stapled hemorrhoidectomy

Prospective, Multicenter Randomized Controlled Trial Comparing Two Hemorrhoidopexy Staplers: The HEMOSTASIS Study

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