Impact of stapled haemorrhoidopexy on stool continence and anorectal function: long-term follow-up of 242 patients.
OBJECTIVE
Several studies have proved the feasibility and safety of stapled anopexy for treating haemorrhoidal prolapse. However, stool urgency and faecal incontinence as possible side effects are still debated. Therefore, the present study was designed to assess the impact of Longo's procedure on stool continence and anorectal function.


METHODS
From 1999 to 2005, 300 patients underwent stapled haemorrhoidopexy for symptomatic haemorrhoidal prolapse. Two hundred forty-two patients (100 women, 142 men) were available for follow-up and were retrospectively reviewed. All operations were performed by one single surgeon. To evaluate anorectal function, the results of a validated incontinence score (total incontinence score [IS]: 0 = best, 20 = worst) and evacuation score (total evacuation score [ES]: 0 = worst, 28 = best) were compared pre- and postoperatively.


RESULTS
The total IS showed no difference in means before and after operation (p = 0.875, CI 95%) retrospectively. Concerning the ES, paired sample t-test showed a weak positive correlation, indicating a significant difference in score means (p = 0.041, CI 95%). The group means changed from 26.24 before operation to 26.60 after the follow-up period.


CONCLUSIONS
The present data revealed no significant negative impact of Longo's technique on anorectal function. In contrast, according to the evacuation score, the results showed a significant improvement of evacuation.
Riss
Stefan
S
Department of General Surgery, Hartmannspital, Vienna, Austria. stefan.riss@meduniwien.ac.at
Riss
Philipp
P
Schuster
Michael
M
Riss
Thomas
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005242:Fecal Incontinence / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006484:Hemorrhoids / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology* / Q000601:surgery; D012005:Rectal Prolapse / Q000601:surgery*; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D017792:Surgical Stapling