Stapled hemorrhoidopexy as a day-surgery procedure

Area of Science:

• Colorectal Surgery
• Minimally Invasive Procedures

Background:

• Stapled hemorrhoidectomy (Procedure for Prolapse and Hemorrhoids - PPH) has gained global acceptance.
• Day-surgery protocols aim to shorten recovery and reduce healthcare costs.

Purpose of the Study:

• To evaluate the safety and efficacy of a day-surgery protocol for stapled hemorrhoidopexy.
• To assess outcomes for patients with symptomatic Grade III and IV hemorrhoid disease.

Main Methods:

• A prospective study of 292 patients undergoing outpatient stapled hemorrhoidopexy (2003-2008).
• Procedures performed using PPH 01 to PPH 03 staplers under spinal or local anesthesia.
• Pain assessed via Visual Analog Scale; clinical evaluations at 7 days, 6 months, and 1, 3, 5 years.

Main Results:

• Mean surgery time was 18 minutes.
• 39 patients (13.3%) experienced complications requiring extended observation (urine retention, pain, bleeding).
• 4 patients (1.4%) were rehospitalized for bleeding; 21 (7.2%) reported transient fecal urgency. No anal incontinence reported.

Conclusions:

• Stapled hemorrhoidopexy is a safe and effective day-surgery procedure for advanced hemorrhoids.
• The complication rate in this day-surgery setting is comparable to inpatient procedures.
• This protocol facilitates shorter recovery and cost reduction.