title: Long-term outcomes of stapled hemorrhoidopexy.
abstract: BACKGROUND
  Hemorrhoidal disease is one of the commonest anorectal disorders worldwide. Stapled hemorrhoidopexy (SH) is a treatment modality associated with low postoperative pain and early mobilization.
  
  
  OBJECTIVE
  To assess long-term outcomes after SH.
  
  
  METHODS
  All 326 patients who underwent SH in 1999-2003 were invited by mail to participate. For each patient we analyzed their medical records, and conducted a questionnaire survey and a digital rectal examination.
  
  
  RESULTS
  Only 91 patients attended the final examination and the mean ± SD follow-up time was 8.7 ±1.2 years. Recurrences were diagnosed in one third of the 91 subjects. There were correlations between recurrences and: the duration of disease (p = 0.047); female gender (p = 0.037); and childbirth (vaginal delivery) (p = 0.026). Sixty-seven patients (73.6%) were satisfied with the outcomes. In the group of dissatisfied patients symptoms such as pain (p = 0.0001), burning (p = 0.0002) and itching (p = 0.014) were most common. Long-term outcomes were good with 75% and 88% reductions in pain sensation and severe and moderate hemorrhoidal bleeding. Pruritus, burning and discomfort resolved in more than 50% of patients. Flatus incontinence, fecal incontinence, or soiling occurred in 21%, 11%, and 32% of patients.
  
  
  CONCLUSIONS
  Long-term results of stapled hemorrhoidopexy are satisfactory in most patients. The 36% recurrence rate correlates with the degree of hemorrhoidal prolapse before the operation, duration of the disease, female gender, and previous vaginal delivery.
authors.affiliation: Department of General and Vascular Surgery, Ceynowa Hospital, Wejherowo, Poland.
authors.forename: Maciej
authors.initials: M
authors.lastname: Michalik
authors.affiliation: Department of General and Vascular Surgery, Ceynowa Hospital, Wejherowo, Poland.
authors.forename: Maciej
authors.initials: M
authors.lastname: Pawlak
authors.affiliation: Department of Surgical Oncology, Medical University of Gdansk, Poland.
authors.forename: Maciej
authors.initials: M
authors.lastname: Bobowicz
authors.affiliation: Department of General and Vascular Surgery, Ceynowa Hospital, Wejherowo, Poland.
authors.forename: Mieczysław
authors.initials: M
authors.lastname: Witzling
keywords: anorectal surgery; hemorrhoids; stapled hemorrhoidopexy
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