Long-term Outcome of Stapled Hemorrhoidopexy for Grade III and Grade IV Hemorrhoids |
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Authors: | Francesco Ceci MD Marcello Picchio MD Domenico Palimento MD Benedetto Calì MD Sergio Corelli MD Erasmo Spaziani MD PhD |
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Institution: | (1) Department of Surgery, Civil Hospital “A. Fiorini, ” Terracina, Latina, Italy;(2) Department of Surgery, Civil Hospital “S. Paolo, ” Naples, Italy;(3) Department of Surgery, University of Rome “La Sapienza, ” Polo Pontino, Terracina, Latina, Italy;(4) Via Papiniano, 2, 104100 Latina, Italy |
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Abstract: | Purpose This study was designed to assess the long-term results of stapled hemorrhoidopexy in 291 patients with Grade III and Grade
IV hemorrhoids after a minimum follow-up of five years.
Methods Records of patients submitted to stapled hemorrhoidopexy for Grade III and Grade IV hemorrhoids between January 1999 and December
2002 were retrospectively analyzed. Long-term outcome was evaluated with a standardized questionnaire and an office visit,
including anorectal examination and rigid proctoscopy.
Results A total of 291 patients with Grade III (57.4 percent) and Grade IV (42.6 percent) hemorrhoids were evaluated. Intraoperative
(20.3 percent) and postoperative (4.8 percent) bleeding was the most frequent complication. The questionnaire was submitted
to all patients at a median follow-up of 73 (range 60–93) months. There were no symptoms related to hemorrhoids in 65.3 percent
of patients, moderate symptoms in 25.4 percent of patients, and severe symptoms in 9.3 percent of patients. Fifty-three (18.2
percent) patients had recurrence. Reoperation was necessary in 21 (7.2 percent) patients (4 in Grade III hemorrhoids and 17
in Grade IV hemorrhoids; P < 0.001), with no recurrent symptoms and/or prolapse. Patient satisfaction for operation was 89.7 percent.
Conclusions Stapled hemorrhoidopexy is a safe and effective treatment for Grade III and Grade IV hemorrhoids. Recurrence requiring reoperation
was higher in Grade IV hemorrhoids than in Grade III hemorrhoids.
Reprints are not available. |
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Keywords: | Hemorrhoids Stapled hemorrhoidopexy Long-term outcome |
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