Day-surgery stapled prolassectomy: a "ten minutes job"

Area of Science:

• Colorectal Surgery
• Surgical Innovation
• Anorectal Disorders

Background:

• Hemorrhoidal disease pathophysiology involves connective tissue deterioration and prolapse, not just venous issues.
• Stapled prolassectomy, introduced in the late 1990s, offers a physiological approach to hemorrhoid treatment.

Purpose of the Study:

• To evaluate the efficacy and safety of stapled prolassectomy for hemorrhoidal disease.
• To assess pain control, recovery, and complication rates associated with the procedure.

Main Methods:

• 50 patients underwent stapled prolassectomy under local-regional anesthesia (ASA I, age 18-65).
• Pre-medication included oral Atropine and Flunitrazepam; topical Lidocaine/Procaine and local anesthetic block were administered.
• Anesthesiologist presence ensured optimal intraoperative care.

Main Results:

• 92% of patients experienced optimal intraoperative pain control; 8% reported mild pain.
• No conversions to general anesthesia were required.
• 88% of patients were discharged same-day; 9% experienced early postoperative complications requiring overnight stay.

Conclusions:

• Stapled prolassectomy is a gold standard for hemorrhoid treatment, preserving anal physiology.
• The procedure results in less postoperative pain and reduced risk of long-term complications like scarring and soiling.
• Day surgery potential offers faster recovery, earlier return to work, and potential healthcare cost reduction.