Experience of 3711 stapled haemorrhoidectomy operations

Background: Stapled haemorrhoidectomy has been routinely performed in the Department of Colorectal Surgery, Singapore General Hospital since 1999. Methods: A retrospective review was undertaken of all patients who underwent stapled haemorrhoidectomy between October 1999 and May 2004. The outcomes studied were patient profiles, priority of operation, indications for surgery, length of operation, postoperative complications and recurrences. Results: A total of 3711 patients (51(.)1 percent women) had the surgery. The median patient age was 50 (range 18-88) years. The main indications were bleeding (80(.)7 percent), haemorrhoidal prolapse (59(.)6 per cent) and thrombosis (3(.)9 per cent). The median duration of operation was 15 (range 5(.)45) min. Minor complications occurred in 12-3 per cent of patients: acute retention of urine (4(.)9 per cent), bleeding (4(.)3 per cent), significant postoperative pain requiring admission (1(.)6 per cent), anorectal stricture (1(.)4 per cent), perianal haematoma (0(.)05 per cent) and significant residual skin tags (0(.)05 per cent). One patient developed a perianal abscess after stapled haemorrhoidectomy. Anastomotic dehiscence occurred in three patients (0(.)08 per cent). Twelve (0(.)3 per cent) patients had a recurrence at a median of 16 (range 5(.)45) months. Conclusion: Considerable experience of stapled haemorrhoidectomy confirms it as a safe and effective procedure.