title: Six years after: complications and long-term results after stapled hemorrhoidopexy with different devices.
abstract: OBJECTIVE
  Stapled hemorrhoidopexy (SH) was introduced in 1998. Early in the experience, a standard circular stapler was often used, while later specifically designed staplers for SH were developed. Although the diameter of the circular cutting knife differ significantly, it remains unclear, if the volume of the excised tissue differs and if this has an influence on the long-term results and complications.
  
  
  METHODS
  We evaluated in a prospective consecutive database that underwent SH from January 2003 through April 2004. There were three devices used during the study period: end-to-end-anastomosis (EEA) 31, stapler device for haemorrhoids (SDH) and procedure for prolapse and haemorrhoids (PPH). Procedure selection was at the discretion of the surgeon; however, the indications for surgery were similar for all involved surgeons. Demographic and operative characteristics were analysed. Follow-up data were collected continuously over the time, and in May 2010, these patients received a questionnaire. Data were compared by t test and chi-square test, respectively.
  
  
  RESULTS
  There were 214 (97 females) evaluable patients. Seventy-three patients were operated with EEA-31, 52 with SDH- and 89 with PPH. The median follow-up was 6.8 years and complete data were available for 131 (61.2%) patients. Demographic characteristics were comparable within the three groups. SDH (6 ml) and PPH (6.5 ml) resected significantly (p < 0.05) more tissue than EEA (5 ml). Early postoperative incontinence rate was significantly higher in the PPH group (6%) as compared to EEA (1%) and SDH (0%). The incidence of other early complications was similar across techniques. The overall complication rates and reoperation rates were similar. Although 41% of the patients had minor anorectal complaints (itching and soiling), incontinence rates were low (2-3%) without any significant differences between the devices.
  
  
  CONCLUSIONS
  The results of cohort of SH patients support the conclusion that short- and long-term outcomes are device independent, although each approach is associated with a modest degree of ongoing anorectal symptoms.
authors: Proctological Office, Kiel, Germany. info@proktologie-kiel.de
authors: Volker
authors: V
authors: Kahlke
authors: Jens Uwe
authors: JU
authors: Bock
authors: Hans Günter
authors: HG
authors: Peleikis
authors: Johannes
authors: J
authors: Jongen
mesh_terms: D000328:Adult; D000368:Aged; D004867:Equipment Design; D005242:Fecal Incontinence / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006484:Hemorrhoids / Q000601:surgery*; D006801:Humans; D007443:Intussusception / Q000601:surgery; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000209:etiology; D012002:Rectal Diseases / Q000601:surgery; D012005:Rectal Prolapse / Q000601:surgery; D012086:Reoperation; D013528:Surgical Staplers