title: Stapled hemorrhoidopexy: functional results, recurrence rate, and prognostic factors in a single center analysis.
abstract: OBJECTIVE
  Since its introduction, stapled hemorrhoidopexy (SHP), the so-called Longo procedure, became a widely accepted treatment option for prolapsing hemorrhoids. Nevertheless, from the early years, concerns grew about the early functional results and potential recurrences. In order to evaluate of SHP with special respect to early defecation disorders und recurrences, our single institute high-volume results were evaluated.
  
  
  METHODS
  One thousand one hundred forty-four consecutive patients with SHP for prolapsing hemorrhoids were evaluated in a period from January 2007 to December 2013. In a prospective analysis, patients were followed with special respect to postoperative complications, functional disorders, mainly perianal irritation, stenosis, and recurrence.
  
  
  RESULTS
  During the timeframe, a total of 663 men and 481 women were treated for prolapsing hemorrhoids. The mean age was 52.6 years (±14.4 years). Indication for surgery was prolapsing hemorrhoids in all cases. In addition to prolapse, 90 patients (7.9 %) suffered from bleeding, 96 patients (8.4 %) had itching, and 95 (8.3 %) had anal wetness; the mean operative time was 11 min (±4 min). Patients were treated as inpatients; the mean hospital stay was 3 days (±1 day). Early complications were observed in 14 patients (1.2 %). The follow-up revealed inflammatory reaction at the stapleline in 8 patients (0.7 %) and rectal stenosis in 22 cases (1.9 %), and recurrence was observed in 46 cases (4.0 %).
  
  
  CONCLUSIONS
  The data presented here provide evidence that SHP is a save procedure with a very low rate for functional disorders and low recurrence rate. Therefore, in our hands, SHP remains standard for prolapsing hemorrhoids.
authors.affiliation: Outpatient Center for Surgery and Proctology Sondershausen, Sondershausen, Germany.
authors.forename: Arndt
authors.initials: A
authors.lastname: Voigtsberger
authors.affiliation: Outpatient Center for Surgery and Proctology Sondershausen, Sondershausen, Germany.
authors.forename: Lucia
authors.initials: L
authors.lastname: Popovicova
authors.affiliation: Department of General and Visceral Surgery, Red Cross Hospital Sondershausen, Sondershausen, Germany.
authors.forename: Gunter
authors.initials: G
authors.lastname: Bauer
authors.affiliation: Outpatient Center for Surgery and Proctology Sondershausen, Sondershausen, Germany.
authors.forename: Knut
authors.initials: K
authors.lastname: Werner
authors.affiliation: Outpatient Center for Surgery and Proctology Sondershausen, Sondershausen, Germany.
authors.forename: Tina
authors.initials: T
authors.lastname: Weitschat-Benser
authors.affiliation: Department of General and Visceral Surgery, Asklepios Hospital Altona, Paul-Ehrlich-Str. 1, 22763, Hamburg, Germany. sv.petersen@asklepios.com.
authors.forename: Sven
authors.initials: S
authors.lastname: Petersen
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D006484:Hemorrhoids / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012008:Recurrence; D017792:Surgical Stapling
keywords: Complication; Hemorrhoid; Prolapse; Recurrence; Surgery