title: Does stapled anopexy for bleeding haemorrhoids cure associated anaemia?
abstract: OBJECTIVE
  The aim of this study was to evaluate the effectiveness of stapled anopexy (SA) in patients with chronic bleeding haemorrhoids and secondary anaemia.
  
  
  METHODS
  Our department performed 340 SA procedure per patient for haemorrhoids between January 1999 and December 2011. Fifty (14.7%) of these patients (25 male patients and 25 female patients) had anaemia (haemoglobin concentration < 13 g/dl in male patients and < 12 g/dl in female patients) secondary to chronic haemorrhoidal bleeding. Patients with colorectal bleeding and anaemia not caused by haemorrhoids were excluded. The mean (SD) age was 56.4 (13.9) years and the mean (SD) haemoglobin concentration was 9.2 (1.6) g/dl for male patients and 10.4 (1.2) g/dl for female patients. Five (10%) patients with anaemia had Grade II, 22 (44%) had Grade III and 23 (46%) had Grade IV haemorrhoids. The median (range) duration of postoperative follow-up was six (1-12) years.
  
  
  RESULTS
  None of the patients required early postoperative admission or experienced early or late complications related to SA. The procedure was successful (normal haemoglobin concentration and no bleeding at 6 months postsurgery) in 45 (90%) patients. Of the five (10%) patients in whom SA was ineffective, one had Grade II, three had Grade III and one had Grade IV haemorrhoids. All these patients underwent Milligan-Morgan haemorrhoidectomy 3 months after SA.
  
  
  CONCLUSIONS
  SA is an effective treatment for patients with bleeding haemorrhoids and subsequent anaemia. In our experience, the success rate was satisfactory and there were no serious complications.
authors.affiliation: Unit of Colorectal Surgery, General and Digestive Surgery Department, Hospital de Mataró, Mataró, Spain.
authors.forename: L A
authors.initials: LA
authors.lastname: Hidalgo-Grau
authors.forename: S
authors.initials: S
authors.lastname: Llorca-Cardeñosa
authors.forename: A
authors.initials: A
authors.lastname: Heredia-Budó
authors.forename: Ò
authors.initials: Ò
authors.lastname: Estrada-Ferrer
authors.forename: M
authors.initials: M
authors.lastname: Del Bas-Rubia
authors.forename: E M
authors.initials: EM
authors.lastname: García-Torralbo
authors.forename: X
authors.initials: X
authors.lastname: Suñol-Sala
mesh_terms: D000328:Adult; D000368:Aged; D000740:Anemia / Q000097:blood / Q000209:etiology / Q000601:surgery*; D002908:Chronic Disease; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D006470:Hemorrhage / Q000209:etiology / Q000601:surgery*; D061865:Hemorrhoidectomy; D006484:Hemorrhoids / Q000150:complications / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D017792:Surgical Stapling
chemical_list: D006454:Hemoglobins
keywords: Anaemia; haemoglobin levels; haemorrhoids; stapled anopexy