title: Long-term results after stapled hemorrhoidopexy: a prospective study with a 6-year follow-up.
abstract: BACKGROUND
  Stapled hemorrhoidopexy was introduced in 1998 as a new technique for treating advanced hemorrhoidal disease. Despite a clear perioperative advantage regarding pain and patient comfort, literature reviews indicate a higher recurrence rate for stapled hemorrhoidopexy than for conventional techniques.
  
  
  OBJECTIVE
  Our aim was to present long-term on the use of this technique.
  
  
  METHODS
  Observational study.
  
  
  METHODS
  Consecutive patients with hemorrhoid prolapse treated at a regional surgical center from May 27, 1999, through December 31, 2003.
  
  
  METHODS
  Stapled hemorrhoidopexy with accompanying resection of residual hemorrhoidal nodules if necessary.
  
  
  METHODS
  Standardized patient questionnaire regarding satisfaction, resolution of symptoms, and performance of further interventions.
  
  
  RESULTS
  Of 257 patients (82 female, 175 male, mean age 53 ± 13 years) undergoing stapled hemorrhoidopexy, follow-up data were available for 224 patients (87.2%) with a mean duration of 6.3 ± 1.2 years. Of these, 195 patients (87.1%) were satisfied or very satisfied with the operation outcome; 19 patients (8.5%) were moderately satisfied; and 10 (4.5%) were not satisfied. Regarding preoperative anal symptoms, complete relief was observed in 179 patients (80.6%) for prolapse, 172 (77.5%) for bleeding, 139 (85.3%) for mucus discharge, 139 (78.5%) for burning sensation, and 115 (75.5%) for itching. Considering all recorded symptoms, 194 patients (86.6%) reported absence and or an improvement at follow-up. Twelve patients (5.4%) reported newly developed incontinence in the sense of urge symptoms; 42 patients out of 51 patients (82.4%) with preexisting incontinence reported an improvement. Local or topical retreatment (ointment, suppositories, sclerotherapy) was performed in 48 patients (21.4%). Reoperation for residual or newly developed hemorrhoidal nodules was needed in 8 patients (3.6%).
  
  
  CONCLUSIONS
  Lack of a comparative group.
  
  
  CONCLUSIONS
  Our long-term results show that this strategy for stapled hemorrhoidopexy can achieve a high level of patient satisfaction and symptom control, with a low rate of reoperation for recurrent hemorrhoidal symptoms.
authors.affiliation: Department for Surgery and Center for Minimally Invasive Surgery, Kliniken Essen-Mitte, Evang. Huyssens-Stiftung, Essen, Germany. aommer@online.de
authors.forename: A
authors.initials: A
authors.lastname: Ommer
authors.forename: Jakob
authors.initials: J
authors.lastname: Hinrichs
authors.forename: Horst
authors.initials: H
authors.lastname: Möllenberg
authors.forename: Babji
authors.initials: B
authors.lastname: Marla
authors.forename: Martin Karl
authors.initials: MK
authors.lastname: Walz
mesh_terms: D000328:Adult; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006484:Hemorrhoids / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000517:prevention & control; D011446:Prospective Studies; D012007:Rectum / Q000601:surgery*; D012008:Recurrence; D012086:Reoperation; D011795:Surveys and Questionnaires; D013536:Suture Techniques / Q000295:instrumentation*; D013537:Sutures; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult