title: [First experience in surgical treatment of hemorrhoidal disease using the PPH stapler].
abstract: BACKGROUND
  Haemorrhoidal disease is a frequent entity worldwide. The surgical management is indicated in third or fourth degree internal hemorrhoidal disease. The conventional hemorrhoidectomy has showed good results but the severe postoperative pain is an important complain. Currently diverse surgical alternatives have been described, mainly to avoid the postoperative pain that follows surgical hemorrhoidectomy. One of these new options is the stapled hemorrhoidectomy using the PPH stapler. This procedure may produce less postoperative pain, with a shorter inpatient stay and faster return to work.
  
  
  OBJECTIVE
  The aim of this paper is to analyze the results of using the Procedure for Prolapsed Hemorrhoids (PPH) as treatment in Hemorrhoidal Disease.
  
  
  METHODS
  This is an observational and descriptive study, where 17 patients underwent stapled hemorrhoidectomy with PPH procedure, between March 2000 and August 2003.
  
  
  RESULTS
  52.8% of this patients presented grade three internal hemorrhoids and 47.2% grade four; 52.9% presented mild postoperative pain; 41.2% moderate and 5.9% severe pain. In a short and median follow up, due to the persistence of hemorrhoidal disease symptoms two patients required surgical re-intervention. Two more patients presented incontinency. One patient presented stenosis in the line of staples treated satisfactory with an anal dilatation session.
  
  
  CONCLUSIONS
  The use of PPH is a feasible and safe procedure and it could be a surgical alternative in the treatment of hemorrhoidal disease, even before than conventional hemorrhoidectomy.
authors.affiliation: * Servicio de Cirugía de Colon y Recto, Departamento de Cirugía, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, México, D F.
authors.forename: José Martín
authors.initials: JM
authors.lastname: Morales-Olivera
authors.forename: Liliana
authors.initials: L
authors.lastname: Velasco
authors.forename: Orlando
authors.initials: O
authors.lastname: Bada-Yllán
authors.forename: Omar
authors.initials: O
authors.lastname: Vergara-Fernández
authors.forename: Takeshi
authors.initials: T
authors.lastname: Takahashi-Monroy
mesh_terms: D000328:Adult; D005260:Female; D006484:Hemorrhoids / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000517:prevention & control; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D013528:Surgical Staplers; D017792:Surgical Stapling; D016896:Treatment Outcome