Jp. Arnaud et al., Treatment of hemorrhoids with circular stapler, a new alternative to conventional methods: A prospective study of 140 patients, J AM COLL S, 193(2), 2001, pp. 161-165
BACKGROUND: Surgical hemorrhoidectomy has a reputation for being a painful
procedure. The aim of this study was to determine the efficacy and safety o
f a new procedure for surgical treatment of hemorrhoid disease.
STUDY DESIGN: From April 1998 to August 1998, 140 patients (83 men and 57 w
omen) with an average age of 43.8 years (range 19 to 83 years) underwent he
morrhoidectomy using a circular stapler. Operative times, peri- and postope
rative complications, mean hospital stay, assessment of the postoperative p
ain, period of incapacity for work, and functional results were collected.
All patients were evaluated at 2 weeks, 2 months, and 18 months after opera
tion.
RESULTS: The average length of the operation was 18 minutes (range 8 to 60
minutes). There were no perioperative complications. The postoperative comp
lication rate was 6.4% (n = 9). Mean hospital stay was 36 hours (range 8 to
72 hours). Paracetamol was the only analgesic used. Eighty-three patients
(59.3%) required analgesic for less than 2 days, 45 patients (32.1%) betwee
n 2 and 7 days, and 12 patients (8.6%) more than 7 days. No patients had an
al wound care. One hundred four patients had professions. The period of inc
apacity for work was less than 5 days for 22 patients (21.1%), between 3 an
d 7 days for 13 patients (12.5%), between 7 and 14 days for 62 patients (59
.6%), and more than 14 days for 7 patients (6.8%). At 18 months, 95.7% of p
atients were fully satisfied with the results, 3.6% were somewhat satisfied
(n = 4), and 0.7% were unsatisfied.
CONCLUSIONS: Treatment of hemorrhoids with a circular stapler appears to be
safe, effective, and rapid, causing few postoperative complications and mi
nimal postoperative pain. At 18 months, 95.7% of the patients were fully sa
tisfied with the results. (J Am Coll Surg 2001; 193:161-165. (C) 2001 by th
e American College of Surgeons).