B. Mlakar () • P. Košorok Medical Centre IATROS Parmova 51b 1000 Ljubljana, Slovenia E-mail: bmlakardobnik@hotmail.com Introduction Third- and four-degree haemorrhoids require surgical treat- ment. Stapled haemorrhoidopexy for prolapsed haemor- rhoids is gaining wide acceptance among coloproctologists in Europe [1–3]. Several prospective randomized trials have demonstrated that this new technique, in the short term, is as effective as the standard Milligan-Morgan haemorrhoidecto- my but better tolerated by patients due to less postoperative pain and an earlier return to work [4–7]. The number of patients who undergo ambulatory surgery for haemorrhoids has been increasing over the past few years [8–11]. This report describes our experience with ambulatory stapled haemorrhoidopexy. Patients and methods From January 2000 to January 2003, ambulatory stapled haemor- rhoidopexy under spinal anaesthesia was performed in 214 patients with third- and fourth-degree haemorrhoids. They were dismissed 3–6 hours after the procedure was completed. They received oral and written instructions for postoperative care and the surgeon’s telephone number in case of emergency. Postoperatively, non- steroidal anti-inflammatory drugs (NSAIDs) and a synthetic ana- logue of codein (tramadol) were used as painkillers. All patients received pre- and postoperative metronidazole per os (400 mg, three times daily for 3 days). In the evening, the patients were con- tacted by phone. Digital examination and proctoscopy were performed 1 and 4 weeks after the operations. Patients assessed postoperative pain one week after surgery on a 10-cm linear visual analogue scale (VAS). Follow-up by mailed questionnaire ranged from 4 to 36 months (mean, 22 months). Patients were asked about problems such as: bleeding, pain after defecation, prolapse, incontinence, faecal urgency, and also if they were satisfied with the operation. The patients with complaints were re-examined. Anorectal manometry was performed in patients with continence disorders (faecal B. Mlakar • P. Košorok Complications and results after stapled haemorrhoidopexy as a day surgical procedure Received: 29 May 2003 / Accepted: 15 July 2003 ORIGINAL ARTICLE Abstract Background The aim of this report is to describe our experience with stapled haemorrhoidopexy as a day surgery procedure. Methods From January 2000 to January 2003, a total of 214 patients with third- and fourth-degree haemorrhoids underwent stapled haemorrhoidopexy under spinal anaesthesia. We analysed early postoperative compli- cations and long-term results. Patients were followed for 4–36 months (mean, 22 months). Only 3 patients (1%) were hospitalised. The long-term complications were analysed by means of a mailed questionnaire. Results Minor bleeding at wiping after defecation was observed by 9% of patients and minor haemorrhoidal prolapse by 8% of patients. Pain after defecation was reported by 6% of patients and anal stenosis occurred in 2% of them. Faecal urgency was reported by 3% of patients with previously unknown incontinence prob- lems. Conclusion According to our experience, stapled haemorrhoidopexy can be safely performed as a day surgery procedure. Key words Stapled haemorrhoidopexy • Day surgery • Complications • Results Tech Coloproctol (2003) 7:164–168 DOI 10.1007/s10151-003-0029-1 © Springer-Verlag 2003