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Stapled haemorrhoidectomy: bothersome staple line bleeding
Dean C S Koh1, Denis M O Cheong, Kutt Sing Wong
1Department of General Surgery, Tan Tock Seng Hospital, Singapore. Dean_Koh@ttsh.com.sg
Asian Journal of Surgery
|July 19, 2005
Summary
Staple line bleeding is a common complication of stapled hemorrhoidectomy, affecting nearly half of patients. Meticulous surgical technique is crucial to prevent postoperative bleeding and reduce patient morbidity.
Area of Science:
- Colorectal Surgery
- Surgical Complications
- Hemorrhoidal Disease Treatment
Background:
- Stapled hemorrhoidectomy is a popular treatment for prolapsing hemorrhoidal disease.
- Staple line bleeding is a recognized contributor to postoperative morbidity.
Purpose of the Study:
- To assess the incidence of intraoperative staple line bleeding during stapled hemorrhoidectomy.
- To evaluate the management and early postoperative outcomes related to staple line bleeding.
Main Methods:
- Retrospective analysis of 39 consecutive stapled hemorrhoidectomy procedures over one year.
- Review of outpatient, operative, and inpatient records.
- Assessment of intraoperative bleeding, management, and postoperative outcomes.
Main Results:
- Intraoperative staple line bleeding occurred in 44% of patients, requiring suture reinforcement in 31%.
- Postoperative bleeding led to admission for 23% of patients, with 10% requiring surgical hemostasis.
- Patients with intraoperative bleeding had a higher incidence of postoperative bleeding (35% vs. 14%).
Conclusions:
- Staple line bleeding is a technical challenge in stapled hemorrhoidectomy.
- Meticulous hemostatic suture placement is essential to minimize postoperative bleeding and re-operation rates.