Randomized clinical trial of stapled haemorrhoidopexy versus conventional diathermy haemorrhoidectomy.Stapled hemorrhoidopexy and Milligan Morgan hemorrhoidectomy in the cure of fourth-degree hemorrhoids: long-term evaluation and clinical results.Primary and repeated stapled hemorrhoidopexy for prolapsing hemorrhoids: follow-up to five years.Long-term results after stapled hemorrhoidopexy: high patient satisfaction despite frequent postoperative symptoms.The unusual complications described (rectal perforation, pelvic sepsis, rectovaginal fistulas) might suggest that the operation should be performed by experienced colorectal surgeons who are familiar with the technique and aware of the possible complications. The complications are similar to those of other techniques and are easily resolved. Stapled hemorrhoidopexy is a significantly less painful operation and offers significant advantages in terms of hospital stay and symptom control in the long term, making for a significantly earlier return to work. In 3 cases we underestimated the extent of the mucosal prolapse and the patients were reoperated on by stapled transanal rectal resection after one (2 patients) and two years. We had one case of rectovaginal fistula in a young woman. Complete or incomplete recurrence occurred in 10 cases (2.2%). Severe pain, when present, may depend on technical failure or learning curve. Urge to defecate, although present in 14% of patients, disappears in a few weeks. Bleeding in the early postoperative period occurred in 3.9% of all patients and in 7 cases (1.5%) reoperation was necessary. Patient's satisfaction is the best response to all criticism. A visual analog scale was used for postoperative pain scoring. Patients were assessed by structural interview to assess their symptoms before and after surgery, and surgical and functional outcome was assessed at 1, 3, 6, 12 and 24 months.
Four hundred and forty-nine patients with haemorrhoids of all degrees and mucosal rectal prolapse were treated at our institution over a five-year period (1999-2004). The follow-up shows better symptom control than other surgical techniques. N2 - Stapled hemorrhoidopexy (SH) presents a number of complications which differ from those of traditional haemorrhoidectomy (Milligan-Morgan, diathermy haemorrhoidectomy). Stapled hemorrhoidopexy (SH) presents a number of complications which differ from those of traditional haemorrhoidectomy (Milligan-Morgan, diathermy haemorrhoidectomy).