Circumferential mucosectomy with stapled proctopexy is a safe, effective outpatient alternative for the treatment of symptomatic prolapsing hemorrhoids in the elderly

Abstract

CMSP is a safe, effective, time-efficient procedure for patients with mucosal prolapse and prolapsing hemorrhoids that can be performed safely in the ambulatory surgery center setting. Age is not a limiting factor in selecting patients for this safe outpatient procedure.

Low-dose spinal hyperbaric bupivacaine for adult anorectal surgery: a double-blinded, randomized, controlled study

“…Urinary retention developed in 18.1% of patients, with 3.4% requiring catheterization of the urinary bladder in the ward. According to other authors, urinary retention developed in 2-7% [30,31] to 13% [32] of patients after hemorrhoidectomy. Lau and Lam [33] stated that urinary retention developed in 4.1% of cases after surgery; its risk factors are advanced age, anorectal surgery, and spinal anesthesia.…”

Stapled Anopexy: Postoperative Course and Functional Outcome in 400 Patients

“…This technique allows reduction of hemorrhoidal prolapse and decreases the risk of bleeding, probably interrupting the hemorrhoidal vessels. 5,6 The main advantage of stapled anopexy is postoperative patient comfort. According to literature, patients submitted to stapled anopexy require significantly less postoperative analgesia and show earlier return to unrestricted activity compared with traditional hemorrhoidectomy.…”

Massive prolapsed haemorrhoids managed by ablation and correction in a poor resourced area

“…In this patient with such a wide extension of the external component outside the anal verge, a more expensive alternative might be to use two staplers simultaneously [8]. In areas with limited health resources, an alternative surgical method for the irreducible massive circumferential prolapsed (fourth degree) haemorrhoids is an excision followed by a modified ‘Delorme's’ correction approach, if there is associated rectal prolapse as in this case, so as to reduce rectal mobility and prevent recurrence [9, 10]. …”