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Long-term results of stapled haemorrhoidopexy in a prospective single centre study of 153 patients with 1–6 years’ follow-up

Authors

  • R. Gerjy,

    1. Division of Surgery, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University
    2. Department of Surgery, County Council of Östergötland, Linköping, Sweden
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  • K. Derwinger,

    1. Colorectal Surgery, Department of Surgery, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden
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  • A. Lindhoff-Larson,

    1. Division of Surgery, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University
    2. Department of Surgery, County Council of Östergötland, Linköping, Sweden
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  • P.-O. Nyström

    1. Department of Clinical Sciences, Intervention and Technology, CLINTEC, Karolinska Institutet
    2. Colorectal Surgery, Department of Surgical Gastroenterology, Karolinska University Hospital Huddinge, Stockholm, Sweden
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Dr Roger Gerjy, Department of Surgery, University Hospital, SE-581 85 Linkoping, Sweden.
E-mail: roger.gerjy@lio.se

Abstract

Aim  The long-term results of stapled haemorrhoidopexy for prolapsed haemorrhoids were assessed using uniform methods to acquire data and pre-set definitions of failure, recurrence, residual symptoms and impaired continence.

Method  From October 1999 to May 2005, 153 patients underwent a stapled haemorrhoidopexy and were enrolled prospectively. They were assessed preoperatively, postoperatively and at the end of the study from replies to a questionnaire about symptoms and continence. Preoperatively, manual reduction of prolapse was required in 103 patients, skin tags were found in 115 patients (circumferential in 22) and impaired continence in 63.

Results  In all, 145 patients completed preoperative and long-term protocols and were analysed as paired data, at a mean follow-up of 32 months. Failure to control the prolapse or recurrence was seen in 19 (13%) patients including nine reoperations for prolapse. Symptoms improved from 8.1 to 2.5 points on a 15-point scale (= 0.001). Symptoms were not controlled in 25 (17%) patients. Continence improved from 4.7 to 2.9 points on a 15-point scale (= 0.001). Twenty-five (17%) patients still had a continence disturbance. Altogether 51 (35%) patients had a deficient outcome with respect to prolapse, symptoms or continence. There were no major adverse events.

Conclusion  Restoration of the anal anatomy by stapled haemorrhoidopexy resulted in a significant improvement in haemorrhoid-associated symptoms and continence but a third of patients had poor symptom control including 13% with persisting prolapse.

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