Dr Mark Cheetham and colleagues at St Mark's Hospital in London, England, investigated the long-term efficacy of stapled hemorrhoidectomy in 22 patients with prolapsing internal hemorrhoids.
"Surgeons who have experience of stapled hemorrhoidectomy urgently need to assess whether any of their patients have suffered long-term complications."
Dr Mark Cheetham
Sixteen of the 22 patients completed over 6 months of post-operative follow-up, 5 of whom developed symptoms of severe pain and fecal urgency.
Symptoms persisted for up to 15 months after the initial operation, and 2 patients are now unable to work because of the severity of their symptoms.
Hemorrhoidectomy almost always cured hemorrhoids and can be performed on a day-surgery basis.
Pre-operative laxatives and post-operative metronidazole are prescribed to reduce pain in the immediate post-operative period. However, the procedure is still uncomfortable and patients typically take 2 weeks off work after the operation.
Stapled hemorrhoidectomy involves the resection of a small "doughnut" section of the rectal mucosa. The research team suggest that post-operative complications may be linked to the removal of smooth muscle as part of the "doughnut".
Dr Cheetham concludes that the "high occurrence of long-term complications after stapled hemorrhoidectomy far outweighs the short-term benefits" of the procedure.