Stapled Hemorrhoidopexy With Longo Process in the Treatment of 3rd and 4th Degree Internal Hemorrhoids and Rectal Mucosal Prolapsus: A Prospective Study

Abstract

Background: The hemorrhoid surgery done with a circular stapler is becoming increasingly common in recent years. 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. In this study Longo process was used the treatment of 3rd and 4th degree internal hemorrhoids and rectal mucosal prolapsus. 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. Circular stapler method using the procedure for proplase & hemorrhoids (PPH03) kit (Ethicon PROXIMATE® PPH) was applied to all cases. Results: Patients’ average pain score was 2 on a Visual Analogue Scale of 10. Most patients have no pain at all immediately after surgery. Symptom were bleeding in 2 patients, pain in 12 patients, and gas passing in 4 and constipation in 10 patients. Patients were followed for a median of 14 months. In 6 patients, pain was observed which responded to medical treatment, symptomatic skin pile was found in 4 patients. None of the patients had septic complication, incontinence and evidence of anal stenosis. Conclusion: hemorrhoidectomy with Longo is easily used acceptable treatment due to shorter healing process and less pain.