All of the patients had prolapsed internal hemorrhoids and rectal mucosal prolapse. In the study, 14 of the 18 patients were male and 4 female. Histological analyses were done to detect skeletal or smooth muscle fibers. At discharge from the hospital, the patients received lactulose, 20 mL daily and basic analgesia. Pain therapy consisted of a basic analgesia and addition of injections of contromal, 100 mg i.m.
Pain scores were evaluated 12 hours later and postoperative 3rd days. A visual analog scale for scoring pain was filled out by the patients postoperatively (0 indicates no pain and 10, maximum pain). Bath sitting 2 to 3 times per day was advised to all patients and all were seen 2-4 weeks post-operatively to allow assessment and possible digital dilation of the staple line in case of stenosis. The average length of hospital stay was 36 hours (24-48). Then, a hemorrhoidal circular stapler was positioned and fired (Figure 1-4).
A purse-string suture with 2-0 polypropylene (Prolene Ethicon, Inc.) was placed circumferentially 4 cm above the dentate line, around 2cm cranial to the upper border of the hemorrhoids, through the window of anoscope. The prolapsed mucous membrane fallen into the lumen of the circular anal dilatator. Then, obturator was removed and circular anal dilator was fixed with 4 stitches at the anal verge. In the techniques, the prolapse of the anoderm and parts of the anal mucous membrane were reduced with the obturator and circular anal dilatator. Circular stapler method using the procedure for proplase & hemorrhoids (PPH03) kit (Ethicon PROXIMATE® PPH) was applied to all cases. First-generation cephalosporin was given for prophylaxis one hour before the operation. A cleaning enema was given preoperatively. The operation was performed under spinal anesthesia in lithotomy position by the same surgeon (Y.Y). Gender, complaints, the degree of hemorrhoids, operative time, and length of hospital stay, postoperative complications and pain were investigated in all patients. Journal of Gastroenterology and Hepatology Research 2015 4(8): 1730-1733 Available from: URL: īetween January 2012-January 2015, at Diyarbakir Gazi Yasargil Training and Research Hospital General Surgery Clinic, a total of 18 patients with complaints of 3rd and 4th degree internal hemorrhoids and mucosal rectal prolapse were included in this prospective study. Stapled Hemorrhoidopexy With Longo Process in the Treatment of 3rd and 4th Degree Internal Hemorrhoids and Rectal Mucosal Prolapsus: A Prospective Study.
Key words: Longo Stapled hemorrhoidopexy Hemorrhoids None of the patients had septic complication, incontinence and evidence of anal stenosis.Ĭonclusion: hemorrhoidectomy with Longo is easily used acceptable treatment due to shorter healing process and less pain.
#Stapled hemorrhoidopexy complications skin#
In 6 patients, pain was observed which responded to medical treatment, symptomatic skin pile was found in 4 patients. Patients were followed for a median of 14 months. Symptom were bleeding in 2 patients, pain in 12 patients, and gas passing in 4 and constipation in 10 patients. Most patients have no pain at all immediately after surgery. Results: Patients’ average pain score was 2 on a Visual Analogue Scale of 10. Materials and Methods: Between January 2012-January 2015, at Diyarbakir Gazi Yasargil Training and Research Hospital General Surgery Clinic, a total of 18 patients with complaints of 3rd and 4th degree internal hemorrhoids and mucosal rectal prolapse were included in this prospective study. In this study Longo process was used the treatment of 3rd and 4th degree internal hemorrhoids and rectal mucosal prolapsus. Longo process first described in 1998 is a stapled hemorrhoidopexy (SH) makes transverse mucosal-submucosal rectal resection in the anal channel using the circular stapler. Background: The hemorrhoid surgery done with a circular stapler is becoming increasingly common in recent years.
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