An Early Experience of Stapled Hemorrhoidectomy in a Medical College Setting

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.