title: Stapled anopexy: postoperative course and functional outcome in 400 patients.
abstract: OBJECTIVE
  We performed a retrospective analysis of postoperative course and functional outcome after at least six months' follow-up in a series of 400 consecutive patients who underwent stapled anopexy.
  
  
  METHODS
  All patients were evaluated at one week and one month after surgery and then according to symptoms. A clinical or telephone follow-up was obtained for all patients. The last 50 patients were prospectively evaluated with an obstructive defecation syndrome score and Wexner continence and constipation score before operation and six months after anopexy.
  
  
  RESULTS
  There were no intraoperative complications. Postoperative bleeding that requires reoperation was observed in 11 patients, most cases (9/11) occurring in the early experience (first 50 patients). After a median follow-up of 6.1 years, four patients required reoperation. After anopexy, we observed an improvement in patients who present disturbance in defecation. The difference between the median obstructive defecation syndrome score before and after operation was statistically significant. Wexner score showed improvement without significant difference.
  
  
  CONCLUSIONS
  Treatment of hemorrhoids with circular stapler seems to be effective with low morbidity and high satisfaction rate because of reduced postoperative pain and rapid recovery. This technique also allows improvement of obstructive defecation symptoms, which are seldom studied in patients with hemorrhoids.
authors.affiliation: Department of General and Minimally Invasive Surgery, Istituto Clinico Humanitas IRCCS, Via Manzoni 56, 20089, Rozzano (Milano), Italy. stefano.bona@humanitas.it
authors.forename: Stefano
authors.initials: S
authors.lastname: Bona
authors.forename: Francesco
authors.initials: F
authors.lastname: Battafarano
authors.forename: Uberto
authors.initials: U
authors.lastname: Fumagalli Romario
authors.forename: Mauro
authors.initials: M
authors.lastname: Zago
authors.forename: Riccardo
authors.initials: R
authors.lastname: Rosati
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003113:Colonoscopy; D003672:Defecation; D005260:Female; D005500:Follow-Up Studies; D006484:Hemorrhoids / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012008:Recurrence; D012189:Retrospective Studies; D017792:Surgical Stapling; D016896:Treatment Outcome