Most complications (65%) occurred after the surgeon had more than 25 case experiences of stapled hemorrhoidectomy. Fissure was treated by dilatation in 57%.
Anal stenoses were treated by dilatation in 55% and by anoplasty in 45%. All hemorrhoidal thromboses were excised. Recurrent hemorrhoids were treated by ligation in 40% and by Milligan-Morgan procedure in 32%.
PPH STAPLED HEMORRHOIDECTOMY SKIN
The most common complication after 1 week was recurrence of hemorrhoids in 2.3% of patients, severe pain (1.7%), stenosis (0.8%), fissure (0.6%), bleeding (0.5%), skin tag (0.5%), thrombosis (0.4%), papillary hypertrophy (0.3%) fecal urency (0.2%), staples problems (0.2%), gas flatus and fecal incontinence (0.2%), intramural abscess, partial dehiscence, mucosal septum and intussusception (each <0.1%). One patient with anastomotic dehiscence needed pelvic drainage and colostomy formation. Bleeding was treated surgically in 24%, with Foley insertion 15% and by epinephrine infiltration in 2% 53% of patients with bleeding received no treatment and 6% needed transfusion. Immediate complications (first week) were: severe pain in 5.0% of all patients, bleeding (4.2%), thrombosis (2.3%), urinary retention (1.5%), anastomotic dehiscence (0.5%), fissure (0.2%), perineal intramural hematoma (0.1%), and submucosal abscess (0.1%). A review of 1,107 patients treated with SH from twelve Italian coloproctological centers has revealed a 15% (164/1,107) complication rate. Stapled hemorrhoidectomy (SH), a new approach to the treatment of hemorrhoids, removes a circumferential strip of mucosa about four centimeters above the dentate line.
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