Stapled Hemorrhoidopexy: Results, Late Complications, and Degree of Satisfaction After 16 Years of Follow-Up

Abstract

BACKGROUND: Stapled hemorrhoidopexy has been widely used for the treatment of hemorrhoids, but concerns about complications and recurrences after prolonged follow-up are still under debate. AIMS: The aim of this study was to evaluate the very long-term results of the stapled hemorrhoidopexy technique. METHODS: Stapled hemorrhoidopexy was performed on 155 patients between 2000 and 2003, and the early results have already been published. In this study, we evaluated the same patients after a very long follow-up. Data were collected with regard to late complications, rate and timing of recurrences, and patients' degree of satisfaction. RESULTS: From a total of 155 patients, 98 patients were evaluated: 59 (60.2%) were interviewed by telephone and 39 (39.8%) were evaluated by outpatient consultation. The mean follow-up was 193 months (range: 184-231), 52 were female, 52 were grade III hemorrhoids, and 46 were grade IV. Recurrence was higher in grade IV (26.1%) than in grade III (7.7%) (p=0.014). Recurrence after prolonged follow-up was seen in 16 patients (16.3%) and 11 (11.2%) required reoperations. The complications were skin tags (3.1%), anal sub-stenosis (2.1%), and fecal incontinence (2.1%). After a prolonged follow-up, 82.5% of patients were either very satisfied or satisfied with the surgery. CONCLUSIONS: Stapled hemorrhoidopexy is a safe and effective treatment for hemorrhoidal disease grades III and IV. Recurrence is higher for grade IV hemorrhoids and may occur up to 9 years of follow-up. Reoperations were infrequent and there is a high patient's degree of satisfaction associated with this technique.

Establishment and validation of clinical prediction model for hemorrhoid recurrence after procedure for prolapse and hemorrhoids

“…However, in the long term, PPH surgery has a high recurrence rate of prolapse, which varies widely from different literature descriptions, ranging from approximately 4% to 26%. [4][5][6][7][8] Recurrence of hemorrhoids decreases patient satisfaction with treatment, causes inconvenience to patients' lives, and may also incur the cost of retreatment. In this study, we analyzed the clinical data of patients after PPH to identify the risk factors associated with hemorrhoidal recurrence and constructed a statistical model to predict hemorrhoidal recurrence after PPH.…”

“…[2] PPH has become an effective option for the treatment of hemorrhoids because of its simplicity, short operative time, minimal pain, and quick recovery. [3,4] Therefore, this procedure has been widely used in many centers. However, in the long term, PPH surgery has a high recurrence rate of prolapse, which varies widely from different literature descriptions, ranging from approximately 4% to 26%.…”