Circular Stapled hemorrhoidopexy (CSh), characterized by a circular incision of the rectal mucosa,[1] is an effective technique for treating prolapsing hemorrhoids. However, the incidence of postoperative urgency and anal stenosis was reported to be as high as 40 %[2] and 6 %,[3] respectively.
Removal of large areas of the anoderm and hemorrhoidal rectal mucosa, without the sparing of adequate mucocutaneous bridges, can lead to scarring and a progressive chronic stricture.[3], [4]
These complications, might be related to the presence of too many staples in the sensitive lower rectum and the nature of the staple line (full circumference).[5]
Treatment
Before treatment
In comparison to CSH, TST is associated with:[5]
- Less postoperative pain
- Fewer episodes of urgency
- No postoperative anal incontinence
- No anal stenosis
After treatment
Indication
- Grade II-IV hemorrhoids
- Partial hemorrhoids
- Circular hemorrhoids
[1] Longo A. Treatment of hemorrhoidal disease by reduction of mucosa and hemorrhoidal prolapse with a circular suturing device: a new procedure. Proceedings of the 6th world Congress of endoscopic surgery. 1998;777-84.
[2] Fueglistaler P, Guenin Mo, Montali I. Long-term results after stapled hemorrhoidopexy: high patient satisfaction despite frequent postoperative symptoms. Dis Colon Rectum. 2007;50:204-12.
[3] Brisinda G, Vanella S, Cadeddu F. Surgical treatment of anal stenosis. World J Gastroenterol. 2009;15:1921-8.
[4] Brisinda G. how to treat haemorrhoids. Prevention is best; haemorrhoidectomy needs skilled operators. BMJ. 2000;321:582-3.
[5] Lin hC, Ren DL, he qL, Peng h, Xie SK, Su D, et al. Partial stapled hemorrhoidopexy versus circular stapled hemorrhoidopexy for grade.
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