The stapled hemorrhoidopexy syndrome: a new clinical entity?

Area of Science:

• Gastroenterology
• Colorectal Surgery

Background:

• Haemorrhoidal disease is common, with unknown etiology.
• Stapled hemorrhoidopexy (SH), or the Longo procedure, is a widely adopted treatment for prolapsing hemorrhoids.
• Concerns regarding serious adverse events from SH were noted in 2000, but subsequent discussion has been limited.

Purpose of the Study:

• To investigate the incidence and characteristics of a specific post-operative syndrome following stapled hemorrhoidopexy.
• To identify potential risk factors associated with the development of this syndrome.

Main Methods:

• A modified stapled hemorrhoidopexy (SH) technique was performed on 205 patients.
• Patient outcomes were monitored for the development of a specific post-operative syndrome.

Main Results:

• A low incidence of overall post-operative complications (11/205) was observed.
• However, 36.58% of patients developed a syndrome including urgency, foreign body sensation, incomplete defecation, and anal discomfort within 48 hours of surgery.
• No statistically significant relationship was found between the syndrome and gender, muscle fibers in the resected ring, hemorrhoidal disease severity, age, or ring length.

Conclusions:

• The stapled hemorrhoidopexy syndrome (SHS) is likely a consequence of the stapled hemorrhoidopexy procedure.
• The irritating presence of titanium staples in the rectal mucosa and the resection itself are hypothesized as the primary causes of SHS.