The stapled hemorrhoidopexy syndrome: a new clinical entity?

Tech Coloproctol. 2011 Oct:15 Suppl 1:S95-9. doi: 10.1007/s10151-011-0741-1.

Abstract

Purpose: Haemorrhoidal disease is a rather common disease of unknown cause. A new technique for treating prolapsing haemorrhoids known as the stapled hemorrhoidopexy (SH) or the "Longo procedure" is widely used. Serious adverse events were reported in 2000 and some discussion over the syndrome but nothing since.

Methods: Two hundred and five patients underwent SH by our surgical team at the Interbalkan European Medical Center. Modified SH was performed.

Results: Despite the low incidence of postoperative complications (11/205), 36.58% of patients developed syndrome comprised of urgency to defecate, sensation of anal foreign body and incomplete defecation and mild cramp like anal discomfort, immediately after surgery or in the following 48 h. There is not statistically significant relationship between the presence of the syndrome and the gender, the presence of muscle fibres in the resected "ring" the degree of haemorrhoidal disease, age and ring length.

Conclusion: Observations led us to conclude that the stapled hemorrhoidopexy syndrome (SHS) is probably caused by the irritating presence of the titanium staples in the rectal mucosa and by the resection itself.

MeSH terms

  • Adult
  • Aged
  • Anal Canal / physiopathology*
  • Chi-Square Distribution
  • Defecation / physiology
  • Female
  • Hemorrhoids / pathology
  • Hemorrhoids / surgery*
  • Humans
  • Male
  • Middle Aged
  • Morpholines / therapeutic use
  • Parasympatholytics / therapeutic use
  • Postoperative Complications / drug therapy
  • Postoperative Complications / etiology
  • Postoperative Complications / physiopathology*
  • Retrospective Studies
  • Sensation / physiology
  • Statistics, Nonparametric
  • Surgical Stapling / adverse effects*
  • Sutures / adverse effects*
  • Syndrome
  • Young Adult

Substances

  • Morpholines
  • Parasympatholytics
  • pinaverium