Stapled anastomosis for anterior resection is safe even after previous stapled haemorrhoidectomy--a report of five cases

Int J Colorectal Dis. 2010 Dec;25(12):1503-6. doi: 10.1007/s00384-010-0994-6. Epub 2010 Jun 25.

Abstract

Introduction: Stapled haemorrhoidectomy has become popular for the treatment of symptomatic bleeding or prolapsing piles. There are concerns about the safety of another stapled low colorectal anastomosis after rectal resection if a patient who has had previous stapled haemorrhoidectomy subsequently develops colorectal neoplasia requiring an anterior resection.

Methods: A retrospective review of patients who underwent stapled haemorrhoidectomy and subsequently had anterior resection from 1999 to 2008 was performed.

Results: Five patients (all male) were found to have distal sigmoid or rectal tumours on surveillance colonoscopy after stapled haemorrhoidectomy. Median age was 65 years (range 58-71). All underwent anterior resection with stapled end-to-end colorectal anastomosis at median of 29 months (range 18-60 months) after the initial stapled haemorrhoidectomy. Median anastomotic height was 12 cm (range 1-12 cm). A defunctioning ileostomy was created for three out of five patients. All the colorectal anastomoses healed uneventfully.

Conclusions: Stapled colorectal anastomosis may be safely performed after previous stapled haemorrhoidectomy.

MeSH terms

  • Aged
  • Anastomosis, Surgical / methods*
  • Colorectal Neoplasms / surgery*
  • Hemorrhoids / surgery*
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications
  • Recurrence
  • Retrospective Studies
  • Surgical Stapling / methods*
  • Treatment Outcome