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Main Disadvantages of Stapled Hemorrhoidopexy

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Book cover Hemorrhoids

Part of the book series: Coloproctology ((COLOPROCT))

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Abstract

The Longo technique, described in 1993, is proposed for the treatment of hemorrhoidal disease. The stapled hemorrhoidopexy has been introduced as an alternative to conventional hemorrhoidectomy. Despite a clear perioperative advantage regarding pain and patient comfort, the stapled hemorrhoidopexy may be followed by unusual postoperative complications. Complications may occur after stapled hemorrhoidopexy, some are particularly serious, especially bleeding and sepsis. Since 2002 more than 130 articles have been published reporting complications during and after stapled hemorrhoidopexy.

Complications were classified as being either early or late if they occurred within 7 days of the operation. Those occurring after 7 days were considered to be late.

The most common complication is early bleeding. Severe postoperative pain could be caused by dehiscence of the anastomosis or due to the fact that the anastomosis is too near to the linea dentata.

A lot of long-term complications have been described. Most of them are related to either an incorrect indication for surgery or technical errors. Severe complications leading to death have been described but are rare. The persistent anal pain after stapled hemorrhoidopexy has in the most cases the objective findings of the staple line hardened and fixed to muscular layer beyond. Irreversible urge incontinence due to lesions of the sphincter muscle or a diminished rectal capacity due to resection of too much mucosa is quite common complication if the procedure is not performed properly. Rectovaginal fistulas and anastomotic diverticula are very rare but possible.

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Authors and Affiliations

  1. Department of General Surgery, Colorectal and Pelvic Floor Diseases Center, S. Maria dei Battuti Hospital, Via Brigata Bisagno, 4, 31015, Conegliano Veneto (TV), Italy

    Michele Schiano di Visconte

  2. Department of General Surgery, Azienda Sanitaria Universitaria Integrata - University of Trieste -, Trieste, Italy

    Arianna Pasquali & Tommaso Cipolat Mis

Authors
  1. Michele Schiano di Visconte
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  2. Arianna Pasquali
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  3. Tommaso Cipolat Mis
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Corresponding author

Correspondence to Michele Schiano di Visconte .

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Editors and Affiliations

  1. Catholic University , Rome, Italy

    Carlo Ratto

  2. Catholic University, Rome, Catholic University, Rome , Rome, Italy

    Angelo Parello

  3. DepartofSurgicalSciences,ProctologyUnit, Catholic University DepartofSurgicalSciences,ProctologyUnit, Rome, Italy

    Francesco Litta

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Schiano di Visconte, M., Pasquali, A., Cipolat Mis, T. (2017). Main Disadvantages of Stapled Hemorrhoidopexy. In: Ratto, C., Parello, A., Litta, F. (eds) Hemorrhoids. Coloproctology. Springer, Cham. https://doi.org/10.1007/978-3-319-51989-0_32-1

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  • DOI: https://doi.org/10.1007/978-3-319-51989-0_32-1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-51989-0

  • Online ISBN: 978-3-319-51989-0

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