Stapled haemorrhoidectomy: bothersome staple line bleeding.

Full Abstract

BACKGROUND: The stapled haemorrhoidectomy procedure has been popularized as a painless and effective treatment for prolapsing haemorrhoidal disease. We have noted that staple line bleeding is a contributory factor to postoperative morbidity. METHODS: This was a retrospective analysis of the clinical records of consecutive stapled haemorrhoidectomy procedures performed in patients over a 1-year period. The outpatient, operative and inpatient records were reviewed. We assessed the incidence of intraoperative staple line bleeding, its management and early postoperative outcomes in our patients undergoing stapled haemorrhoidectomy. RESULTS: From March 2000 to March 2001, 39 stapled haemorrhoidectomy procedures were performed. Intraoperative staple line bleeding was recorded in 17 patients (44%) and suture reinforcement of this staple line was required in 12 (31%). Nine patients (23%) were admitted for postoperative per rectal bleeding, four of whom required surgical haemostasis of bleeding points along the staple line. Delayed secondary haemorrhage was seen in one patient. The incidence of postoperative bleeding in patients with noted staple line bleeding was 35%, compared with 14% in those without evidence of bleeding. CONCLUSION: Staple line bleeding is a technical difficulty and complication associated with stapled haemorrhoidectomy. It should be managed with meticulous haemostatic suture placement in order to avoid postoperative bleeding and the morbidity of re-operation for haemostasis.

Author information

Author/s: Koh, Dean C S (DC); Cheong, Denis M O (DM); Wong, Kutt Sing (KS);

Affiliation: Department of General Surgery, Tan Tock Seng Hospital, Singapore. Dean_Koh(-atsign-)ttsh.com.sg

Journal and publication information

Publication Type: Comparative Study; Journal Article

Journal: Asian journal of surgery / Asian Surgical Association (Asian J Surg), published in China. (Language: eng)

Reference: 2005-Jul; vol 28 (issue 3) : pp 193-7

Dates: Created 2005/07/18; Completed 2005/10/18; Revised 2006/11/15;

PMID: 16024315, status: MEDLINE (last retrieval date: 2/18/2009, IMS Date: )

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