Stapled hemorrhoidopexy (procedure for prolapse and hemorrhoids PPHs) is associated with less post-operative pain and quicker recovery compared to conventional hemorrhoidectomy. However, post-operative rectal stricture is a rare but debilitating complication that can lead to significant discomfort and may require additional surgical intervention to correct. We report the case of a 35-year-old male who developed a tight rectal stricture at 4 cm from the anal verge following stapled hemorrhoidopexy performed elsewhere. The patient initially underwent conservative management with stool softeners and serial dilatations, which yielded minimal improvement. The patient subsequently underwent transanal circumferential stapled resection using a Covidien EEA™ circular stapler with Tri-Staple™ technology. After placement of a purse-string suture incorporating the fibrotic segment, the stapler was fired, enabling complete circumferential excision of the stricture with simultaneous stapled anastomosis and restoration of luminal patency. The procedure was uneventful, and the patient was discharged pain-free on post-operative day 1. Conclusion: Transanal circumferential stapled resection represents a safe, effective, and minimally invasive option for managing post-PPH rectal strictures located at or above the dentate line.
Lattoo et al. (Mon,) studied this question.