{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T18:53:23Z","timestamp":1769194403267,"version":"3.49.0"},"reference-count":16,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2007,4,22]],"date-time":"2007-04-22T00:00:00Z","timestamp":1177200000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2007,4,22]],"date-time":"2007-04-22T00:00:00Z","timestamp":1177200000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2007,4,22]],"date-time":"2007-04-22T00:00:00Z","timestamp":1177200000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2007,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Stapled hemorrhoidopexy is used to remove a circumferential strip of mucosa and submucosa about 4\u00a0cm above the dentate line, in order to restore the correct anatomical relationships of the anal canal structures. We evaluated the histological features of the resected tissue obtained after stapled hemorrhoidopexy with correlation to the short\u2010term and mid\u2010term results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective study evaluated 234 cases of stapled hemorrhoidopexy. Data concerning postoperative bleeding, anal pain, incontinence, stenosis, and recurrence of hemorrhoids were collected from hospital and outpatient clinic records. Histologic slides were examined for the type of epithelium, presence of muscle fibers, nerve endings, and degree of vascular ectasia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Some 52% of the biopsies revealed on the surface a combination of glandular with squamous epithelium, meaning a stapling line at the level of the transitional zone\/dentate line. Smooth muscle fibers were more frequent as the stapling line approached the level of the dentate line\/transitional zone (<jats:italic>p<\/jats:italic> = 0.0028). Internal sphincter fibers were present in 36% of the cases, yet there were no cases of anal incontinence. Inclusion of merely squamous epithelium in the resected tissue correlated with severe postoperative pain persisting one week after surgery (<jats:italic>p<\/jats:italic> &lt; 0.0001), whereas the concurrent presence of squamous and glandular epithelium correlated only with severe pain on the first postoperative day (<jats:italic>p<\/jats:italic> = 0.018). Nerve endings were more frequent in patients with anal pain one week after surgery (<jats:italic>p<\/jats:italic> = 0.02). The rate of recurrence of symptoms was 3%, which did not correlate with any of the histological parameters tested.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Though stapled hemorrhoidopexy is performed according to well\u2010established technical guidelines, it is too difficult to be standardized.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-007-9048-9","type":"journal-article","created":{"date-parts":[[2007,4,21]],"date-time":"2007-04-21T16:00:43Z","timestamp":1177171243000},"page":"1338-1344","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Mid\u2010term Results of Stapled Hemorrhoidopexy for Third\u2010 and Fourth\u2010degree Hemorrhoids\u2014Correlation with the Histological Features of the Resected Tissue"],"prefix":"10.1002","volume":"31","author":[{"given":"Gil","family":"Ohana","sequence":"first","affiliation":[{"name":"Proctology Unit Hasharon Hospital 7 Keren Kayemet St. Petach Tikva Israel"},{"name":"Division of Surgery asharon Hospital 7 Keren Kayemet St. Petach Tikva Israel"},{"name":"Sackler Faculty of Medicine Tel\u2010Aviv University Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Boris","family":"Myslovaty","sequence":"additional","affiliation":[{"name":"Proctology Unit Hasharon Hospital 7 Keren Kayemet St. Petach Tikva Israel"},{"name":"Sackler Faculty of Medicine Tel\u2010Aviv University Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arie","family":"Ariche","sequence":"additional","affiliation":[{"name":"Division of Surgery asharon Hospital 7 Keren Kayemet St. Petach Tikva Israel"},{"name":"Sackler Faculty of Medicine Tel\u2010Aviv University Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zeev","family":"Dreznik","sequence":"additional","affiliation":[{"name":"Proctology Unit Hasharon Hospital 7 Keren Kayemet St. Petach Tikva Israel"},{"name":"Division of Surgery asharon Hospital 7 Keren Kayemet St. Petach Tikva Israel"},{"name":"Sackler Faculty of Medicine Tel\u2010Aviv University Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rumelia","family":"Koren","sequence":"additional","affiliation":[{"name":"Department of Pathology Hasharon Hospital 7 Keren Kayemet St. Petach Tikva Israel"},{"name":"Sackler Faculty of Medicine Tel\u2010Aviv University Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lea","family":"Rath\u2010Wolfson","sequence":"additional","affiliation":[{"name":"Department of Pathology Hasharon Hospital 7 Keren Kayemet St. Petach Tikva Israel"},{"name":"Sackler Faculty of Medicine Tel\u2010Aviv University Tel Aviv 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