title: A four-year retrospective study and review of selection criteria and post-operative complications of stapled haemorrhoidopexy.
abstract: BACKGROUND
  Severe life-threatening complications have been reported from the use of procedure for prolapsed haemorrhoids (PPH). First, we assessed post-operative complication rates over 4 years of PPH experience. We then sought to assess the impact of selection criteria for patients receiving PPH on post-operative complication rates and review our findings in the context of published literature.
  
  
  METHODS
  Over a 4-year period 2006-2010 at Hinchingbrooke Hospital, all 118 patients receiving PPH were audited for readmissions with post-operative complications using the admission database. A further retrospective audit of 50 patients' notes assessed the impact of selection criteria for PPH on post-operative complication rates. All PPH operations were performed by one of two senior colorectal consultants using the standard technique with a circular stapler.
  
  
  RESULTS
  Of the 118 patients from the 4-year audit, 12 (10 %) patients were readmitted. Two (1.7 %) of these 12 patients had post-operative pain, six (5.1 %) had rectal bleeding, three (2.5 %) had urinary retention, and one (0.8 %) had localised infection. There was one (0.8 %) patient mortality resulting from severe sepsis from an infected intra-abdominal haemorrhagic collection. In the following audit of 50 patients' notes, 15 patients had internal prolapsed haemorrhoids alone, of which one (6.6 %) experienced post-operative complications compared with six (55 %) of the 11 patients who had haemorrhoids and skin tags.
  
  
  CONCLUSIONS
  With careful selection of patients, PPH may be indicated for prolapsed internal haemorrhoids. More specific national guidelines are required with regard to contraindications to PPH.
authors: Hinchingbrooke Hospital, Hinchingbrooke Park, Huntington, Cambridge, PE29 6NT, UK. jamesfomsf@googlemail.com
authors: J W
authors: JW
authors: Butterworth
authors: R
authors: R
authors: Peravali
authors: R
authors: R
authors: Anwar
authors: K
authors: K
authors: Ali
authors: B
authors: B
authors: Bekdash
mesh_terms: D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D061865:Hemorrhoidectomy / Q000009:adverse effects*; D006484:Hemorrhoids / Q000150:complications / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology; D010359:Patient Readmission; D018579:Patient Selection; D011391:Prolapse; D012189:Retrospective Studies; D012871:Skin Diseases / Q000150:complications; D017792:Surgical Stapling / Q000009:adverse effects; D013530:Surgical Wound Infection / Q000209:etiology; D016055:Urinary Retention / Q000209:etiology