Longo procedure (Stapled hemorrhoidopexy): Indications, results

Area of Science:

• Colorectal Surgery
• Surgical Innovation
• Hemorrhoidal Disease Management

Background:

• Traditional pedicular hemorrhoidectomy (Milligan and Morgan, Ferguson) serves as the established reference procedure.
• Hemorrhoidal disease affects a significant portion of the population, necessitating effective treatment options.

Purpose of the Study:

• To compare the outcomes and patient satisfaction of stapled hemorrhoidopexy (SH) with traditional hemorrhoidectomy.
• To identify optimal patient selection criteria for SH to maximize efficacy and minimize complications.

Main Methods:

• Literature review and data synthesis comparing pedicular hemorrhoidectomy with stapled hemorrhoidopexy (SH).
• Analysis of procedural ease, pain levels, recovery time, recurrence rates, and patient satisfaction.

Main Results:

• SH is associated with simpler execution, reduced postoperative pain, and quicker return to normal activities.
• SH demonstrates high long-term patient satisfaction despite a potential for higher recurrence rates and procidentia.
• Specific patient criteria (reversible prolapse, normal anal caliber, absence of large tags) are essential for successful SH outcomes.

Conclusions:

• Stapled hemorrhoidopexy (SH) is a viable alternative to traditional hemorrhoidectomy for selected patients.
• Elastic band ligation is recommended for persistent prolapse or recurrence post-SH.
• Careful patient selection is paramount for optimizing SH results and patient outcomes.