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Chirurgia 2008 June;21(3):177-80

language: English

Extrasphincteric fistula complicating stapled hemorrhoidopexy: is the procedure always safe? Report of a case

Gentile M., Guarino V., Mosella F., Beneduce L., Mosella G.

Department of General Surgery “Federico II” Medical School of Naples, Italy


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Stapled hemorrhoidopexy is an effective, easy and practical technique for prolapsing hemorrhoids. Some serious although rare complications are described but an extrasphincteric fistula has never been previously reported in the literature as a complication following Longo’s procedure: a case in a previously healthy woman is reported. Different mechanisms may be proposed to explain its onset but technical problems such as a deeply bitten suture must be primarily investigated. Moreover, this can account for other similar septic complications being reported, particularly intraperitoneal catastrophic contamination, emphasizing that the technique is not free from adverse events despite a wide enthusiastic acceptance mainly due to a lesser postoperative pain. The overall incidence and type of complications occurring after this operation demonstrate that, compared to traditional surgery, the need of antibiotic prophylaxis is actually not indicated on the basis of a cost-benefit analysis and a low rate of septic consequences.

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