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Complications, recurrences, early and late reoperations after stapled haemorrhoidopexy: lessons learned from 1,233 cases

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Abstract

Purpose

The purpose of the study was to analyse the outcomes of all patients requiring a reoperation after an initial circular stapled haemorrhoidopexy (SH) for prolapsing haemorrhoids.

Methods

Data of all patients undergoing a circular SH from 1998 thru 2007 available in a prospectively collected database were reviewed, and all patients who had reoperations were studied.

Results

During the study period, 1,233 patients (551 females, median age 52 years) underwent a circular SH. Complete follow-up was available in all patients (median follow-up 7 months, range 0.5–100); 127 patients (10.3%) required one or more reoperations. Early reoperations (<30 days) were necessary in 47 patients (3.8%), and 45 (3.6%) were stapler-related complications. Late reoperations (>30 days) were performed in 84 patients (6.8%) and 57 (4.6%) were stapler-related. A learning curve was observed with significant reduction of early (<30 days) and late (>30 days) reoperation rate with time.

Conclusions

Reoperations after SH are necessary in about 10% of the patients. The majority of the reoperations are due to either complications arising from circular SH, recurrent/persistent haemorrhoidal symptoms or other anorectal issues not addressed by the circular SH procedure (3.8% early; 6.8% late). Circular SH appears to be an effective procedure for symptomatic haemorrhoidal disease; however, training and learning curve issues should be addressed to minimise treatment failures.

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Abbreviations

SH:

stapler haemorrhoidopexy

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Acknowledgements

The authors would like to thank “our ladies in the office” for their ever-lasting engagement and support in continuously collecting the data of the patients for this study. We also thank Dr. Anthony Senagore for his help and stimulating critique on the manuscript.

Author information

Authors and Affiliations

  1. Proctological Office Kiel, Beselerallee 67, 24105, Kiel, Germany

    Johannes Jongen, Anne Eberstein, Jens-Uwe Bock, Hans-Günter Peleikis & Volker Kahlke

  2. Department of Surgical Proctology, Park-Klinik Kiel, Goethestraße 11, 24116, Kiel, Germany

    Johannes Jongen, Hans-Günter Peleikis & Volker Kahlke

Authors
  1. Johannes Jongen
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  2. Anne Eberstein
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  3. Jens-Uwe Bock
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  4. Hans-Günter Peleikis
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  5. Volker Kahlke
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Corresponding author

Correspondence to Johannes Jongen.

Additional information

Part of the data were presented on the annual meeting of the Deutsche Gesellschaft für Chirurgie, Berlin, Germany, April 22–25, 2008, and on the annual meeting of the American Society of Colon and Rectal Surgeons, Boston, MA, USA, June 7–11, 2008.

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Jongen, J., Eberstein, A., Bock, JU. et al. Complications, recurrences, early and late reoperations after stapled haemorrhoidopexy: lessons learned from 1,233 cases. Langenbecks Arch Surg 395, 1049–1054 (2010). https://doi.org/10.1007/s00423-009-0543-3

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