Complications of stapled hemorrhoidectomy: a French multicentric study

• Published in: Gastroentérologie clinique et biologique 2005-04, Vol.29 (4), p.429-433
• Main Authors: Oughriss, Malika, Yver, Renaud, Faucheron, Jean-Luc
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Female; Fistula - etiology; France; Gastroenterology. Liver. Pancreas. Abdomen; Hemorrhoids - surgery; Humans; Male; Medical sciences; Middle Aged; Nephrology. Urinary tract diseases; Other diseases. Semiology; Pain; Postoperative Hemorrhage - etiology; Retrospective Studies; Risk Factors; Sepsis - etiology; Stomach, duodenum, intestine, rectum, anus; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Sutures - adverse effects; Thrombosis; Urinary Retention; Urinary system involvement in other diseases. Miscellaneous; Urinary tract. Prostate gland
• ISSN: 0399-8320
• DOI: 10.1016/S0399-8320(05)80798-5

The aim of this retrospective multicentric study was to assess the complications of the Longo technique for the treatment of haemorrhoidal disease. From March 1999 to April 2003, 550 patients underwent a stapled hemorrhoidectomy following Longo's technique in 12 surgical units in the Rhône-Alpes Region. The operative indications were the same as for conventional hemorrhoidectomy. Complications were divided into early or late complications depending on whether they occurred before or after the 7 th day. For each patient, the most serious complication was retained for analysis. One hundred and five patients (19%), mean age 51 years, experienced complications. The early complications were bleeding (1.8%), severe anal pain (2.3%), urinary retention (0.9%) and sepsis (0.5%). Late complications were chronic anal pain (1.6%), suture dehiscence (1.6%), anal stricture (1.6%), anal fissure (0.9%), external thrombosis (0.9%), fistulae and intramural abscesses (0.9%), anal incontinence (0.3%), haemorrhoidal disease symptoms persistence or recurrence (3.2%). Strictures were successfully dilated, fissures were treated by sphincterotomy, external thromboses were excised and fistulae were laid open. Most of the recurrences were treated with the Milligan-Morgan hemorroidectomy technique. Complications may occur after stapled hemorrhoidopexy, some are particularly serious, especially bleeding and sepsis. L’objectif de cette étude rétrospective multicentrique était d’analyser les complications de la technique de Longo dans le traitement de la maladie hémorroïdaire. Du 1 er mars 1999 au 31 avril 2003, 550 malades ont été opérés selon la technique de Longo dans 12 centres de la région Rhône-Alpes. Les indications opératoires étaient celles de l’hémorroïdectomie classique. Les complications ont été séparées en complications précoces lorsqu’elles survenaient avant le 7 e jour postopératoire et en complications tardives au-delà. Pour chaque malade, seule la complication la plus sévère a été prise en compte. Cent-cinq malades (19 %) d’une moyenne d’âge de 51 ans ont présenté au moins une complication. Les complications précoces étaient des hémorragies (1,8 %), des douleurs anales majeures (2,3 %), des troubles urinaires (0,9 %) et des abcès (0,5 %). Les complications tardives étaient des douleurs chroniques (1,6 %), des déhiscences de suture (1,6 %), des sténoses anales (1,6 %), des fissures anales (0,9 %), des thromboses hémorroïdaires externes (0,9 %), des fistules et des abcès