title: [Results of Longo's stapled hemorrhoidectomy in ambulatory surgery for grade III-IV hemorrhoids].
abstract: BACKGROUND
  We prospectively evaluated the results of stapled hemorrhoidectomy for grade III-IV hemorrhoids in the ambulatory setting.
  
  
  METHODS
  Eighty-five consecutive patients with grade III-IV hemorrhoids, treated with the stapled technique with PPH01 in the Ambulatory Surgery Service of the General Hospital of Valencia were studied. Symptomatic, ASA I-II patients who agreed to undergo ambulatory surgery (vehicle, an accompanying adult, address with telephone, elevator, and basic hygiene conditions) were included.
  
  
  RESULTS
  Thirty-nine percent were women and 61% were men, with a mean age of 47.6 years. A total of 85.9% had grade IV hemorrhoids and 14.1% had grade III. The average surgical time was 29.81+/- 12 minutes with a mean length of hospital stay of 168.88 +/- 88 minutes. Surgical complications consisted of 16 hemorrhages of the staple line (18.8%) and five hemorrhages due to mucous tear (5.9%). During the first 8 days the most frequent complication was pain (45.9%); only 7.1% of the patients required analgesia with opiates, and one patient required admission for 24 hours for analgesic purposes. Bleeding occurred in 10 patients, five of whom reported slight bleeding on defecation that stopped spontaneously; the remaining five required admission for 24 hours after surgical revision. Nine patients (10.6%) were admitted to the hospital for 24 hours, three due to intraoperative hemorrhage, five due to postoperative hemorrhage and one due to pain. A second intervention was required in 8.2%.
  
  
  CONCLUSIONS
  Stapled hemorrhoidectomy can be applied in an ambulatory regime. Although technically simple with a short learning curve, this technique is not free of complications. Suitable patient selection and adequate perioperative information are indispensable for the ambulatory management of this disorder.
authors.affiliation: Servicio de Cirugía Mayor Ambulatoria (UCMA), Consorcio Hospital General Universitario, Valencia, España.
authors.forename: Cristóbal
authors.initials: C
authors.lastname: Zaragozá
authors.forename: Alfonso
authors.initials: A
authors.lastname: García Fadrique
authors.forename: Sergio
authors.initials: S
authors.lastname: Castaño
authors.forename: Raúl
authors.initials: R
authors.lastname: Villalba
authors.forename: Marcos
authors.initials: M
authors.lastname: Bruna Esteban
authors.forename: Carlos
authors.initials: C
authors.lastname: Redondo Cano
mesh_terms: D000556:Ambulatory Surgical Procedures / Q000379:methods*; D005260:Female; D006484:Hemorrhoids / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012720:Severity of Illness Index; D013537:Sutures