[Rectal stenosis following procedure for prolapse and hemorrhoids].
OBJECTIVE
To evaluate stenosis of the lower rectum following PPH with special respect to potential predictive factors or stenotic events.


METHODS
A retrospective analysis of 554 consecutive patients, which underwent PPH from July 2000 to December 2004 was performed.


RESULTS
Only patients with follow-up check were evaluated, thus the analysis includes 489 patients (489/554, 88.3%) with a mean follow-up of (324 +/- 18) days. Rectal stenosis was observed in 12 patients (12/489, 2.5%), the median time to stenosis was 89 - 134 (125 +/- 5) days. All the patients complained of obstructive defecation and underwent strictureplasty with electrocautery or balloon dilation through colonoscopy. A statistical analysis revealed that patients with stenosis had significantly more often prior sclerosis therapy for hemorrhoids (58.3% vs. 20.0%, P = 0.02) and severe postoperative pain (25.0% vs. 6.7%, P = 0.003). Other factors, such as gender (P = 0.32), prior surgery for hemorrhoids (P = 0.11), histological evidence of squamous skin (P = 0.77) or revision (P = 0.53) showed no significance.


CONCLUSIONS
Rectal stenosis is an uncommon event after PPH. Early stenosis will occur within the first four months after surgery. The majority of the stenosis can be cured through colonoscopy surgery. The predictive factors for stenosis are previous sclerosis therapy for hemorrhoids and severe postoperative pain.
Yao
Li-qing
LQ
Department of General Surgery, Zhongshan Hospital, Department of Surgery, Medical Center, Fudan University, Shanghai 200032, China.
Zhong
Yun-shi
YS
Xu
Jian-min
JM
Zhou
Ping-hong
PH
Xu
Mei-dong
MD
Song
Lu-jun
LJ
Liu
Hou-bao
HB
D000328:Adult; D000368:Aged; D003251:Constriction, Pathologic / Q000601:surgery; D005260:Female; D006484:Hemorrhoids / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery*; D011351:Proctoscopy; D012002:Rectal Diseases / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D012005:Rectal Prolapse / Q000601:surgery*; D012189:Retrospective Studies; D017792:Surgical Stapling / Q000009:adverse effects