TITLE:
An Early Experience of Stapled Hemorrhoidectomy in a Medical College Setting
AUTHORS:
Mushtaq Chalkoo, Shahnawaz Ahangar, Naseer Awan, Varun Dogra, Umer Mushtaq, Hilal Makhdoomi
KEYWORDS:
Hemorrhoids, Surgical Treatment, Longo Technique
JOURNAL NAME:
Surgical Science,
Vol.6 No.5,
May
26,
2015
ABSTRACT:
Background: Stapled hemorrhoidectomy,
popularly known as Longo technique is in use for the treatment of hemorrhoids
since its first description to surgical fraternity in the world congress of
endoscopic surgeons in 1998. Objectives: To evaluate the feasibility, patient
acceptance, recurrence and results of stapled haemorrhoidectomy in our early
experience. Methods: Between Jan 2012 and Dec 2013, 42 patients with
symptomatic GRADE III and IV hemorrhoids were operated by stapled
hemorrhoidectomy by a single surgeon at our surgery department. The evaluation
of this technique was done by assessing the feasibility of the surgery; and
recording operative time, postoperative pain, complications, hospital stay,
return to work and recurrence. Results: All the procedures were completed
successfully. The mean (range) operative time was 30 (20 - 45) min. The blood
loss was minimal. Mean (range) length of hospitalization for the entire group
was 1 (1 - 3) days. Only 3 patients required more than 1 injection of
diclofenac (75 mg) while as rest of the patients were quite happy switching
over to oral diclofenac (50 mg) just after a single parenteral dose. All the
patients returned to their routine work in less than a week’s time. The mean
(range) follow-up was 6 (4 - 12) months. There were no major intraoperative or
postoperative complications except for retention of urine in 8 patients. The
patients are still on regular follow-up and have not had recurrence as yet.
Conclusion: Stapled hemorrhoidectomy technique is a safe alternative to the
traditional Milligan-Morgan technique. It can be performed as an office
procedure, is well tolerated by patients and is cost effective than conventional
surgical therapy.