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[Surgical treatment of hemorrhoidal disease using the circular stapler. Analysis of 60 operated cases]
A Farinetti1, M Saviano, N Quaranta
1Dipartimento delle Discipline Chirurgiche e delle Emergenze, Sezione di Clinica Chirurgica, Università degli Studi, Modena e Reggio Emilia, Italy. farinetti.alberto@unimo.it
Background:
The authors describe their experience of the treatment of hemorrhoidal disease using a circular stapler in order to evaluate the effectiveness of this technique.
Methods:
They describe the surgical technique used in a comparative study carried out at Modena Policlinic. A transversal mucohemorrhoidal transection is performed using a circular stapler above the anorectal joint, enabling radical surgery to be completed in a single stage with a rapid and mini-invasive technique. This technique associates the resection of hemorrhoidal nodules and prolapsed mucosa with fixing the residual mucosa to the anal canal and correcting the hypertension and hematic stasis in the venous spaces by breaking the terminal branches of the superior hemorrhoidal artery. Both male and female patients were enrolled in the study, aged over 18 years old, presenting second, third and fourth degree hemorrhoidal prolapse with indications for surgery. The analysis of the long-term follow-up for possible late complications in the 60 selected cases will be reported in a later work.
Results:
The technique is easy, rapid and causes moderate pain. The postoperative complications are negligible.
Conclusions:
A hospital stay limited to a few hours, rapid physical recovery and the absence of out-patient treatment required by this surgical technique, which is comparable to an internal closed hemorrhoidectomy, all offer undoubted advantages, also of a psychological and social nature which amply justify the higher economic and management cost linked to the use of a surgical stapler.
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