Untitled

Abstract

Introduction: Stapled Hemorrhoidopexy (SH) is relatively less painful surgery and treatment of choice for grade III and IV internal hemorrhoids. The current study reveals the long term effectiveness of modified Longo technique in 3130 patients treated at a single center. Methods:All the patients with complaints of hemorrhoids visited Healing Hands Clinic, Pune during study period were evaluated. Patients diagnosed with grade III and grade IV were operated with modified Longo technique Stapled Hemorrhoidopexy .Follow up was done after 15 days, 1month, 3months & 12months. Telephonic follow up was done in patients who were not available. The minimum follow up period was 1 years and maximum 7 years. The data evaluated for pre-operative and post-operative symptoms improvements, resumption to normal activity, treatment satisfaction and recurrence rate and quality of life. Results:The mean surgery time and hospitalization duration were 20 minutes and 18 hours respectively. Post-operatively mild pain was reported by 57.53% (n=1801) patients, by 19.14% (n=599) on day 15, 4.89% (n=153) at 3 Months and no patient had pain at the end of 1 year. Patient's satisfaction on Day 3, 57.82% (n=1810) patient were very satisfied, 33.04% (n= 1034) were moderately satisfied and 9.14 % (n=286) were not satisfied with the treatment. The immediate complications (all mild) included urinary retention (5.69%, n=178), difficult defecation (11.69%, n=366), anal fissure (3.83% (n=120), postoperative bleeding 1.05%, (n=33), and anal stenosis 0.93 %( n=29). All patients returned to normal work / activities in an average of 5 days. There was significant improvement in overall perception of World Health Organization-Quality of life and social, physical, psychological domains after surgery. The recurrence rate at 1 year was 0.23%. Conclusion:Modified Longo Technique of Stapled hemorrhoidopexy is associated with low complications rate, minimal post-operative pain and negligible recurrence rate.