Partial stapled hemorrhoidopexy: a minimally invasive technique for hemorrhoids

Purpose This study was designed to assess the safety, efficacy, and postoperative outcomes of partial stapled hemorrhoidopexy (PSH). Methods A prospective study was conducted between February and March 2010. PSH was performed with single-window anoscopes for single isolated hemorrhoids, bi-window anoscopes for two isolated hemorrhoids, and tri-window anoscopes for three isolated hemorrhoids or circumferential hemorrhoids. The data pertaining to demographics, preoperative characteristics and postoperative outcomes were collected and analyzed. Results Forty-four eligible patients underwent PSH. Single-window anoscopes were used in 2 patients, and bi- and tri-window anoscopes in 6 and 36 patients. The blood loss in patients with single-window, bi-window, and tri-window anoscopes was 6.0 ml (range 5.0–7.0 ml), 5.0 ml (range 5.0–6.5 ml), and 5.0 ml (4.5–14.5 ml) ( P = 0.332). The mean postoperative visual analog scale score for pain was 3 (range, 1–4), 2 (range 1–4), 3 (range 2–6), 1 (range 0–3), 1 (range 0–2) and 2 (range 2–4) at 12 h, days 1, 2, 3, and 7, and at first defecation. The rate of urgency was 9.1%. No patients developed anal incontinence or stenosis. The 1-year recurrence rate of prolapsing hemorrhoids was 2.3%. Conclusions Partial stapled hemorrhoidopexy appears to be a safe and effective technique for grade III–IV hemorrhoids. Encouragingly, PSH is associated with mild postoperative pain, few urgency episodes, and no stenosis or anal incontinence.