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[Rectal stenosis after stapler hemorrhoidopexy].

M Mongardini1, F Custureri, F Schillaci

  • 1Prima Facoltà di Medicina e Chirurgia, Dipartimento di Scienze Chirurgiche, UOC Chirurgia Generale L, Università degli Studi "La Sapienza" di Roma.

Il Giornale Di Chirurgia
|December 8, 2005
PubMed
Summary
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A modified stapled hemorrhoidopexy technique for rectal prolapse presented a rare complication: rectal stenosis. This stenosis was successfully treated non-surgically, highlighting a simple resolution for this specific surgical outcome.

Area of Science:

  • Gastroenterology and Surgical Innovation

Background:

  • Hemorrhoids, rectocele, and rectal prolapse are common conditions often treated surgically.
  • The Procedure for Prolapse and Hemorrhoids (PPH) using stapled hemorrhoidopexy is a recognized treatment.
  • A modified Longo's technique with a double purse string was employed for combined hemorrhoid and prolapse treatment.

Observation:

  • A 52-year-old woman underwent a modified PPH procedure for hemorrhoids, rectocele, and rectal prolapse.
  • The immediate postoperative period was uneventful, with early discharge.
  • On postoperative day five, the patient developed unusual rectal stenosis attributed to the superior purse string.

Findings:

  • Rectal stenosis, a rare complication, occurred due to the superior purse string in the modified PPH.
  • The stenosis was effectively managed through a transanal approach to release the purse string.

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  • Outpatient management was sufficient for resolving the complication.

    • Implications:

    • This case highlights a potential, albeit rare, complication of modified stapled hemorrhoidopexy techniques.
    • The findings suggest that rectal stenosis from purse-string sutures can be managed effectively in an outpatient setting.
    • This underscores the importance of recognizing and managing unusual postoperative complications promptly.