[Treatment of mucous and haemorrhoidal prolapse with circular stapler according to Longo: personal experience]

The authors present their experience with the treatment of haemorrhoidal prolapse using the Longo technique. From March 2005 to February 2006, 56 patients underwent the above-mentioned procedure, 49 of them (87.5%) suffering from third-degree and 7 (12.5%) from fourth-degree prolapse. The most common symptom, present in all patients, was rectal bleeding. Fifty patients (89.3%) were treated as one-day surgery cases. All patients were monitored at 1 week and1 month after the operation, 29 patients (51.8%) were monitored for 6 months postoperatively and 4 patients (7.1%) for 1 year. The mean follow-up was 5.6 months (range: 1 week-1 year). In our experience, the most important clinical evidence consisted in very low postoperative pain intensity, early return to work, a low rate of minor complications and the absence of major complications. It is necessary to ensure that both the details of technique and the indications for the procedure are fully considered and complied with and that an effective learning curve is implemented in order to achieve good postoperative results. We suggest the adoption of an eclectic approach that does not preclude more traditional operative techniques for the treatment of fourth-degree prolapse and prolapse with large external haemorrhoids. We consider this to be a sine qua non for an appropriate surgical approach to the disease.