Stapled hemorrhoidopexy for prolapsed hemorrhoids in patients with liver cirrhosis; a preliminary outcome for 8-case experience.
OBJECTIVE
To investigate the efficacy and safety of stapled hemorrhoidopexy in treating prolapsed hemorrhoids in patients with liver cirrhosis.


METHODS
Eight consecutive cases of patients with prolapsed hemorrhoids comorbid with liver cirrhosis, who had intractable response to other interventions, were enrolled in this retrospective study between January 2002 and June 2006 at our institute. Six patients (75%) had Child-Pugh class A liver cirrhosis, whereas only two patients (25%) had class B disease. Rectal varices were identified in three patients (37.5%), and esophageal varices were identified in six patients (75%). Concurrent rectal and esophageal varices existed in three patients (37.5%). The patients underwent stapled hemorrhoidopexy with Proximate PPH-03 in a lithotomy position under spinal/intravenous general anesthesia.


RESULTS
There was no procedure-related mortality or major complications except hemorrhage. Two patients (25%) were complicated with postoperative staple-line bleeding, which was managed with conservative treatment without reoperation. There were no leading symptoms of relapsing during a follow-up period of at least 6 months.


CONCLUSIONS
This study may prove that stapled hemorrhoidopexy is a feasible and safe approach for prolapsed hemorrhoids concurrent with liver cirrhosis.
Huang
Wen-Shih
WS
Division of Colon and Rectal Surgery, Chang Gung Memorial Hospital, 6, Sec. West, Chia-Pu Road, Putz, Chiayi 613, Taiwan.
Lin
Paul Y
PY
Chin
Chih-Chien
CC
Yeh
Chung-Hung
CH
Hsieh
Ching-Chuan
CC
Chang
Te-Sheng
TS
Wang
Jeng-Yi
JY
D005260:Female; D005401:Fissure in Ano / Q000209:etiology / Q000601:surgery; D006484:Hemorrhoids / Q000150:complications / Q000601:surgery*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000601:surgery; D012189:Retrospective Studies; D017792:Surgical Stapling / Q000009:adverse effects* / Q000379:methods; D013537:Sutures; D016896:Treatment Outcome