Early Experience with Stapled Hemorrhoidopexy in Nairobi, Kenya

Abstract

Background: Conventional hemorrhoidectomy (CH) is considered the gold standard in the surgical management of symptomatic hemorrhoids. It is however painful and has a relatively lengthy convalescence period. In the last two decadescircular mucosectomy using a standard circular stapler has increasingly been performed to mitigate the immediate and short term post-operative shortcomings associated with CH.
Methods: A retrospective study of the patients undergoing stapled hemorrhoidopexy in four private hospitals between December 2009 and February 2011 was carried out. The objective was to report our early experience with stapled hemorrhoidopexy (SH) and document treatment outcome regarding post-operative pain score, length of hospital stay, return to normal activity, treatment complications and patient satisfaction.
Results: Forty five (45) patients with grade III (8.9%, n=4) and grade IV (91.1%, n=41) hemorrhoids underwent SH during the study period. The mean age was 33.3 (17-54) years with 28 (62.2%) males. The mean pain score at the time of discharge using the visual analog scale (VAS) was 4 (2-5). The mean hospital stay in days was 1.9 +/- 0.6. One patient developed sepsis while two (4.5%) had technical failure of the procedure necessitating conventional excisional hemorrhoidectomy under a different surgeon within 8 months of SH. Two thirds (n=30) were very satisfied, 12 (26.7%) were satisfied and 2 (4.4%) were not satisfied with the procedure. The mean overall satisfaction was 85.2% (sd +/- 20.3). 
Conclusion: SH is a safe, convenient and effective treatment of hemorrhoids with a high rate of patient satisfaction.

Key Words: Stapled, Hemorrhoidopexy, Outcome, Kenya