Complications of stapled hemorrhoidectomy: a French multicentric study

Objectives - The aim of this retrospective multicentric study was to assess the complications of the Longo technique for the treatment of haemorrhoidal disease. Methods - From March 1999 to April 2003, 550 patients underwent a stapled kemorrhoidectomy following Longo's technique in 12 surgical units in the Rkone-Alpes Region. The operative indications were the same as for conventional hemorrhoidectomy. Complications were divided into early or late complications depending on whether they occurred before or after the 7(th) day. For each patient, the most serious complication was retained for analysis. Results - One hundred and five patients (19%), mean age 51 years, experienced complications. The early complications were bleeding (1.8%), severe anal pain (2.3%), urinary retention (0.9%) and sepsis (0.5%). Late complications were chronic anal pain (1.6%), suture dehiscence (1.6%), anal stricture (1.6%), anal fissure (0.9%), external thrombosis (0.9%), fistulae and intramural abscesses (0.9%), anal incontinence (0.3%), haemorrhoidal disease symptoms persistence or recurrence (3.2%). Strictures were successfully dilated, fissures were treated by sphincterotomy, external thromboses were excised and fistulae were laid open. Most of the recurrences were treated with the Milligan-Morgan hemorroidectomy technique. Conclusion - Complications may occur after stapled hemorrhoidopexy, some are particularly serious, especially bleeding and sepsis.