Analysis of recurrence after stapled hemorrhoidopexy in grade IV hemorrhoid disease.

Abstract

Background: Stapled hemorrhoidopexy (SH) is one of the most commonly used surgical techniques for hemorrhoidal disease, being particularly effective for grade III and IV hemorrhoids. The procedure is associated with better short-term outcomes, including less postoperative pain, shorter operative time, faster return to work, and higher patient satisfaction. However, there is a risk-benefit debate surrounding SH due to significant complications from the procedure, such as anal stenosis, rectovaginal fistula, fecal incontinence, and recurrence.

Aim: To evaluate recurrence rates and factors influencing surgical outcomes following SH in patients with grade III and IV hemorrhoids.

Methods: This retrospective, single-center study enrolled a total of 77 patients with grade III/IV hemorrhoids for analysis. Early (less than 7 days after SH) and late (7 or more days after SH) complications were analyzed. Recurrence rates were calculated as well.

Results: Patients were categorized by hemorrhoid grade and showed no differences in demographic data between the two groups. Recurrence was observed in 4 patients (23.6%) with grade IV hemorrhoids, and no recurrence was noted in patients with grade III hemorrhoids. Postoperative bleeding, incomplete defecation, urgent defecation, incontinence, skin tags, and anal fissure were complications reported by both groups.

Conclusion: Due to the high recurrence rate, SH is not an appropriate treatment option for patients with grade IV hemorrhoids. Open surgery may be a more suitable option for these patients.