title: Inflammatory polyps: a cause of late bleeding in stapled hemorrhoidectomy.
abstract: OBJECTIVE
  Stapled hemorrhoidectomy has become a popular treatment of hemorrhoids, mainly because of the benefits of greatly reduced postoperative pain. However, complications unique to the new procedure have been reported. This study was designed to review our series of 82 patients with a focus on complications, with particular focus on late bleeding caused by inflammatory polyps at the staple line.
  
  
  METHODS
  A review of 82 patients who underwent stapled hemorrhoidectomy was conducted. Indications included bleeding in 29 patients, prolapse in 19, combined bleeding and prolapse in 31, and pain in 3. The procedure was performed in an outpatient setting with the Ethicon ILS 33 stapler in the standard fashion.
  
  
  RESULTS
  Late bleeding as a result of inflammatory polyps was encountered in nine patients (11 percent). Bleeding was mild, and all cases resolved after excision of the polyps. Other complications occurred with the following frequency: urinary retention (4.9 percent), submucosal hematoma (2.4 percent), early bleeding (1.2 percent), recurrent hemorrhoids (2.4 percent), thrombosed external hemorrhoids (2.4 percent), and fecal urgency (3.7 percent).
  
  
  CONCLUSIONS
  Bleeding from inflammatory polyps occurs in a significant number of patients undergoing stapled hemorrhoidectomy. Mild bleeding several weeks or months after the procedure should prompt a search for inflammatory polyps at the staple line. Simple excision of the polyps was adequate treatment and has not resulted in rebleeding.
authors.affiliation: Department of Surgery, Akron City Hospital, 525 East Market Street, Akron, OH 44309-2090, USA.
authors.forename: John C
authors.initials: JC
authors.lastname: Fondran
authors.forename: Joel A
authors.initials: JA
authors.lastname: Porter
authors.forename: Frederick A
authors.initials: FA
authors.lastname: Slezak
mesh_terms: D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology* / Q000601:surgery; D006484:Hemorrhoids / Q000601:surgery*; D006801:Humans; D007249:Inflammation / Q000150:complications* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011127:Polyps / Q000150:complications* / Q000601:surgery; D011183:Postoperative Complications; D012002:Rectal Diseases / Q000150:complications* / Q000601:surgery; D012007:Rectum; D013528:Surgical Staplers; D013537:Sutures