title: Stapled hemorrhoidectomy for the treatment of hemorrhoids.
abstract: BACKGROUND
  The use of circular staplers in the treatment of hemorrhoidal disease is known as a simple procedure, with low morbidity, less post-treatment pain and with the same efficacy when compared to the classical hemorrhoidectomy.
  
  
  OBJECTIVE
  Analyze the operative technique, intra-operative and immediate postoperative complications and late results in 100 patients treated for hemorrhoid disease by stapling technique.
  
  
  METHODS
  The group included 53 males and 47 females with mean age of 49.8 years, operated during the period June 2000 to June 2002 in the "Hospital Universitário" (São Paulo University Hospital) and "Hospital Sírio Libanês", in São Paulo, SP, Brazil.
  
  
  RESULTS
  The majority of patients (78%) were discharged on the first post-operative day. Eight patients required supplementary analgesia and were given intramuscular diclofenac sodium and four of them received intramuscular tramadol. One intraoperative complication was bleeding which was difficult to control and required a blood transfusion. One patient was reoperated on the first postoperative day due to intermittent and persistent bleeding, however without hemodynamic changes or a drop in hematocrit. Two patients presented hemorrhoidal thrombosis in the early postoperative stage. The postoperative follow-up displayed: recurrence of prolapse, five cases (5%); anal sub-stenosis, two cases (2%); anal fissure, one case (1%); persistent pain, two cases (2%). Seven reoperations were performed: one due to bleeding, one due to sub-stenosis and five due to recurrence of hemorrhoidal prolapse and persistence of symptoms.
  
  
  CONCLUSIONS
  Stapling is simple to accomplish, has low postoperative pain and rate of complications, however, the incidence of late reoperations is rather high and therefore major follow-up for better analysis is required.
authors.affiliation: Hospital Sírio Libanês, São Paulo, Brazil. sergionahas@uol.com.br
authors.forename: Sergio Carlos
authors.initials: SC
authors.lastname: Nahas
authors.forename: Marcelo Rodrigues
authors.initials: MR
authors.lastname: Borba
authors.forename: Maria Cecília Teixeira
authors.initials: MC
authors.lastname: Brochado
authors.forename: Carlos Frederico Sparapan
authors.initials: CF
authors.lastname: Marques
authors.forename: Caio Sérgio Rizkallah
authors.initials: CS
authors.lastname: Nahas
authors.forename: Boulanger
authors.initials: B
authors.lastname: Miotto-Neto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006484:Hemorrhoids / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012008:Recurrence; D012086:Reoperation; D017792:Surgical Stapling; D016896:Treatment Outcome