title: [Modification to stapled mucosectomy technique with PPH. Experience of a surgical group].
abstract: BACKGROUND
  Haemorrhoidal disease is a common disorder. Surgical treatment is indicated in cases of advanced disease. However, postoperative pain, operative time, and technical difficulties have prompted the search for new procedures and improve the existing ones. A modification is proposed to the technique of PPH (Procedure for Prolapse and Haemorrhoids) stapled haemorrhoidectomy that facilitates and standardises the procedure without altering its benefits.
  
  
  OBJECTIVE
  To describe the postoperative results and short-term evolution of patients with internal haemorrhoidal disease, who underwent stapled mucosectomy with PPH with a modified technique.
  
  
  METHODS
  This is a retrospective review of 35 patients who underwent stapled haemorrhoidectomy with a modified technique by the same surgical team.
  
  
  RESULTS
  Twenty-five patients were men (71%) and 10 women (29%). Sixteen patients had grade III internal haemorrhoid disease (46%) and 19 grade IV (54%). The mean operative time was 31 minutes. Six patients had acute urinary retention. There were no cases of severe pain, bleeding, haematoma, stenosis, incontinence, thrombosis, or re-operation. The median hospital stay was 1 day.
  
  
  CONCLUSIONS
  The proposed modification of PPH haemorrhoidectomy is performed with greater technical ease without increased morbidity, preserving the advantages of the original technique.
authors.affiliation: Departamento de Cirugía General, Centro Médico ABC, México, DF, México. Electronic address: edgar.glezm@gmail.com.
authors.forename: Edgar Agustín
authors.initials: EA
authors.lastname: González-Macedo
authors.affiliation: Departamento de Cirugía General, Centro Médico ABC, México, DF, México.
authors.forename: Carlos
authors.initials: C
authors.lastname: Cosme-Reyes
authors.affiliation: Departamento de Cirugía General, Centro Médico ABC, México, DF, México.
authors.forename: Carlos
authors.initials: C
authors.lastname: Belmonte-Montes
mesh_terms: D000328:Adult; D000368:Aged; D004867:Equipment Design; D005260:Female; D061865:Hemorrhoidectomy / Q000379:methods*; D006484:Hemorrhoids / Q000601:surgery*; D006801:Humans; D007413:Intestinal Mucosa / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013528:Surgical Staplers; D017792:Surgical Stapling
keywords: Engrapadora PPH; Haemorrhoidectomy; Hemorroidectomía; Mucosectomía con engrapadora; PPH stapler; Stapled mucosectomy