Stenosis after Stapled Anopexy: Personal Experience and Literature Review

Italo Corsale, Marco Rigutini, Sonia Panicucci, Domenico Frontera and Francesco Mammoliti

Department of General Surgery, Surgical Department ASL Toscana Centro, SS. Cosma e Damiano Hospital - Pescia, Italy

^*Correspondance to: Italo Corsale 

 PDF  Full Text DOI: 10.25107/2474-1647.2140

Abstract

Purpose: Post-operative stenosis following SA is a rare complication, however it can be strongly disabling and require further treatments. Objective of the study is to identify risk factors and procedures of treatment of stenosis after Stapled Anopexy.
Methods: 237 patients subjected to surgical resection with circular stapler for symptomatic IIIIV degree haemorrhoids without obstructed defecation disorders. 225 cases (95%) respected the planned follow-up conduced for one year after surgery.Results: Stenosis was noticed in 23 patients (10.2%), 7 of which (3,1%) complained about “difficult evacuation”. All patients reported symptom atology appearance within 60 days from surgery. Previous rubber band ligation was referred from 7 patients (30,43%) and painful post-operative course (VAS>6) was referred from 11 (47,82%) of the 23 that developed a stenosis. These values appear statistically significant with p<0.05. Previous anal surgery and number of stitches applied during surgical procedure do not appear statistically significant. Symptomatic stenosis was subjected to cycles of outpatient progressive dilatation with remission of troubles in six cases. A woman, did not get any advantage, was been subjected to surgical operation, removing the stapled line and performing a new handmade sutura.Conclusion: The stenosis that complicate Stapled Anopexy are high anal stenosis or low rectal stenosis and they are precocious, reported within 60 days from surgery. If intense post-operative pain occurs (VAS>6), this appears to be related to development of a symptomatic stenosis. Surgery is avoidable in most cases and conservative treatment, as outpatient dilatations, has to be carried out.

Keywords

Stapled hemorrhoidopexy; Stapled anopexy; Rectal stenosis; Anal stenosis

Cite the article

Corsale I, Rigutini M, Panicucci S, Frontera D, Mammoliti F. Stenosis after Stapled Anopexy: Personal Experience and Literature Review. Clin Surg. 2018; 3: 2140.