Longo’s procedure reduces hemorrhoid prolapse using a circular stapler to transversely resect a mucosal-submucosal rectal ring in order to restore the correct anatomical relationships of the anal canal structures. Although stapled hemorrhoidopexy is not associated with any greater morbidity than conventional techniques, some reports have mentioned the persistence of potential unique complications such as postoperative bleeding, pelvic sepsis, and anal stenosis at follow-up. This procedure was first introduced by Longo, and this technique of stapled hemorrhoidopexy has rapidly gained worldwide acceptance. The treatment of hemorrhoidal disease using a circular stapler is a simple procedure with low morbidity and less post-treatment pain, but it has the same efficacy compared to the classical hemorrhoidectomy. Conclusion: Once the learning curve has been completed, a 3-stitch purse-string suture in stapled hemorrhoidopexy could be an alternative to the 6-stitch suture, with effective hemostasis and a shorter operative time. Results: Although there were no statistically significant differences in postoperative complication rates, histological analysis of the excised mucosa, or anorectal function between the 2 groups, the 3-stitch procedure was significantly superior to the 6-stitch procedure in terms of intraoperative hemostasis and operative time, especially in advanced surgery.
The ring of excised rectal mucosa was examined histologically. Operative data and postoperative complications were compared between the 2 groups. Methods: Ninety patients were randomly assigned to undergo stapled hemorrhoidopexy with either a 6-stitch (n = 45) or a 3-stitch (n = 45) purse-string suture. We designed a prospective, randomized study to evaluate the safety and clinical outcome of a 6-stitch purse-string suture compared with a more simple 3-stitch purse-string suture intended to achieve certain interruption of the hemorrhoidal artery. Aim: The purse-string suture is the most important part of the procedure in stapled hemorrhoidopexy affecting resection of an ideal mucosal rectal ring.
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