title: Bleeding after stapled haemorrhoidopexy using the PPH 03 stapler device. Experience and results in 100 consecutive patients.
abstract: Bleeding after stapled haemorrhoidopexy using the PPH 01 device is a relatively frequent major complication. Using the new PPH 03 instrument may enable to achieve better control. From June 2004 to July 2005, 100 patients with 2nd and 3rd degree haemorrhoids and mucosal rectal prolapse were treated at our institution. In all of the cases the PPH 03 instrument was used and the operations were performed by two surgeons with expertise in stapled haemorrhoidopexy. During structural interviews, the patients assessed their symptoms before and after surgery, and surgical outcome was assessed at 1 and 2 weeks. Major bleeding (loss of Hb > 5 points) occurred in 2 patients in the first 10 cases and re-operation was necessary. Minor bleeding (loss of Hb < 3 points) occurred in 2 patients. We had 2 bleeds in the early postoperative period (2%) and 2 cases of late bleeding (2%). Stapled haemorrhoidopexy is an effective treatment for haemorrhoids and is a significantly less painful operation. Any postoperative bleeding that may occur is easy to resolve and its incidence depends on the careful haemostatic control at the staple line. The new PPH 03 stapler device seems to be more effective than the PPH 01 device for control of the staple line suture. We would suggest that colorectal surgeons who are familiar with the technique and aware of possible complications should perform stapled haemorrhoidopexy using the PPH 03 stapler.
authors.affiliation: General and Miniinvasive Surgery Unit, "S. Maria della Pieti" Hospital, Casoria, Napoli.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Angelone
authors.forename: Cristiano
authors.initials: C
authors.lastname: Giardiello
authors.forename: Carmine
authors.initials: C
authors.lastname: Prota
mesh_terms: D000328:Adult; D005260:Female; D006484:Hemorrhoids / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000209:etiology*; D012189:Retrospective Studies; D017792:Surgical Stapling / Q000009:adverse effects* / Q000295:instrumentation*; D016896:Treatment Outcome