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Stapled Hemorrhoidopexy - Initial Experience at a Community Hospital
Lucian Panait, Viraj Bhalani, Thomas Alosco, Stanley J. Dudrick
Saint Mary's Hospital, Waterbury, CT
Objective: To evaluate the initial experience with stapled hemorrhoidopexy at Saint Mary’s Hospital, in Waterbury, CT. We hypothesized that stapled hemorrhoidopexy is associated with decreased operative time, decreased postoperative pain, superior patient recovery and greater patient acceptance, when compared to conventional hemorrhoidectomy.
Design: Retrospective study. Follow-up ranged between 2 and 28 months.
Setting: Community hospital.
Patients: Forty-six patients with third and fourth degree internal hemorrhoids underwent stapled hemorrhoidopexy by a single surgeon at our institution between November 2004 and February 2007. Residents were involved with the operative procedure in all cases.
Interventions: All patients underwent stapled hemorrhoidopexy (the procedure for prolapsed hemorrhoids). The procedure was performed in lithotomy position, under general anesthesia.
Main Outcome Measures: Chart review and telephone interviews were conducted to evaluate the operative time, length of hospitalization, time of return to work or normal activity, duration of postoperative pain, presence of postoperative complications and presence of recurrence.
Results: The average operative time was 35.8 minutes, with longer durations towards the beginning of the study. All cases were performed as an outpatient basis. Postoperative pain was only encountered in 4 patients. One patient was admitted secondary to urinary retention. Most patients resumed normal activities on postoperative day number one. Eight patients had recurrence of hemorrhoidal tissue, but only one required surgical re-intervention.
Conclusions: Although reports in the literature are controversial with regards to stapled hemorrhoidopexy, our initial experience proves it an effective therapeutic method, with increased patient acceptance and early postoperative recovery. Longer follow-up studies are necessary to evaluate the rate of recurrence, as well as the possibility of subsequent employment of stapled hemorrhoidopexy in recurrent cases.
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