Long-term results after stapled haemorrhoidopexy for fourth-degree haemorrhoids: a prospective study with median follow-up of 6 years.
BACKGROUND
The aim of our study was to assess our early and long-term results after stapled haemorrhoidopexy for fourth-degree haemorrhoids.


METHODS
Our study covers the time period from 1998 to 2002 and consists of 56 consecutive patients (33 men) with fourthdegree haemorrhoids who underwent stapled haemorrhoidopexy.


RESULTS
During the postoperative period, 6 patients (10.7%) experienced pain for 7-14 days, which was treated with oral analgesia. Ten patients (17.8%) experienced gas incontinence and two of them also reported soiling. The incontinence subsided within 3-8 weeks. Median follow-up was 72.1 months (range, 55-86 months). Recurrence of the haemorrhoidal disease occurred in 33 patients (58.9%). The overall reintervention rate was 42.8%, as 24 patients required excisional haemorrhoidectomy by the Milligan-Morgan technique at a later stage.


CONCLUSIONS
Stapled haemorrhoidopexy seems to be a safe, low-pain but ineffective technique for the treatment of fourth-degree haemorrhoids, as it is accompanied by high recurrence and reintervention rates in the long term.
Zacharakis
E
E
Fourth Academic Surgical Unit, Aristotle University of Thessaloniki, Thessaloniki, Makedonia, Greece.
Kanellos
D
D
Pramateftakis
M G
MG
Kanellos
I
I
Angelopoulos
S
S
Mantzoros
I
I
Betsis
D
D
D000328:Adult; D000368:Aged; D013505:Digestive System Surgical Procedures / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006484:Hemorrhoids / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000453:epidemiology; D011446:Prospective Studies; D017792:Surgical Stapling; D016896:Treatment Outcome