{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T17:04:57Z","timestamp":1792170297525,"version":"4.4.0"},"reference-count":15,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2013,1,20]],"date-time":"2013-01-20T00:00:00Z","timestamp":1358640000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Surg Innov"],"published-print":{"date-parts":[[2013,12]]},"abstract":"<jats:p>Introduction. Longo\u2019s technique (or PPH technique) is well known worldwide. Meta-analysis suggests that the failure due to persistence or recurrence is close to 7.7%. One of the reasons for the recurrence is the treatment of the advanced hemorrhoidal prolapse with a single stapling device, which is not enough to resect the appropriate amount of prolapse. Materials and methods. We describe the application of \u201cDouble PPH Technique\u201d (D-PPH) to treat large hemorrhoidal prolapses. We performed a multicentric, prospective, and nonrandomized trial from July 2008 to July 2009, wherein 2 groups of patients with prolapse and hemorrhoids were treated with a single PPH or a D-PPH. Results were compared. The primary outcome was evaluation of safety and efficacy of the D-PPH procedure in selected patients with large hemorrhoidal prolapse. Results. In all, 281 consecutive patients suffering from hemorrhoidal prolapse underwent surgery, of whom 74 were assigned intraoperatively to D-PPH, whereas 207 underwent single PPH. Postoperative complications were 5% in both groups ( P = .32), in particular: postoperative major bleeding 3.0% in PPH versus 4.1% D-PPH ( P = .59); pain 37.9 % PPH versus 27.3% D-PPH (mean visual analog scale [VAS] = 2.5 vs 2.9, respectively; P = .72); and fecal urgency 2.1% PPH versus 5.7% D-PPH ( P = .8). Persistence of hemorrhoidal prolapse at 12-month follow-up was 3.7% in the PPH group versus 5.9% in the D-PPH group ( P = .5). Conclusions. Our data support the hypothesis that an accurate intraoperative patient selection for single (PPH) or double (D-PPH) stapled technique will lower in a significant way the incidence of recurrence after Longo\u2019s procedure for hemorrhoidal prolapse.<\/jats:p>","DOI":"10.1177\/1553350612472988","type":"journal-article","created":{"date-parts":[[2013,1,21]],"date-time":"2013-01-21T20:09:22Z","timestamp":1358798962000},"page":"553-558","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["Double PPH Technique for Hemorrhoidal Prolapse"],"prefix":"10.1177","volume":"20","author":[{"given":"A.","family":"Braini","sequence":"first","affiliation":[{"name":"U.O. Chirurgia 2, Az. Ospedaliera S. Maria degli Angeli, Pordenone, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Narisetty","sequence":"additional","affiliation":[{"name":"U.O. Chirurgia 2, Az. Ospedaliera S. Maria degli Angeli, Pordenone, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Favero","sequence":"additional","affiliation":[{"name":"U.O. Chirurgia 2, Az. Ospedaliera S. Maria degli Angeli, Pordenone, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Calandra","sequence":"additional","affiliation":[{"name":"Clinica Chirurgica, Az. Ospedaliera Universitaria S. Maria della Misericordia, Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Calandra","sequence":"additional","affiliation":[{"name":"U.O. Chirurgia Generale, Ospedale di Latisana, Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Caponnetto","sequence":"additional","affiliation":[{"name":"Clinica Chirurgica, Az. Ospedaliera Universitaria S. Maria della Misericordia, Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Digito","sequence":"additional","affiliation":[{"name":"U.O. Chirurgia Generale, Ospedale di S. Daniele, Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"Da Pozzo","sequence":"additional","affiliation":[{"name":"Clinica Chirurgica Generale Az. Ospedali Riuniti di Trieste, Trieste, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Marcotti","sequence":"additional","affiliation":[{"name":"U.O. Chirurgia Generale Ospedali di Tolmezzo e Gemona, Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Porebski","sequence":"additional","affiliation":[{"name":"U.O. Chirurgia Generale Ospedale di Spilimbergo, Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Rovedo","sequence":"additional","affiliation":[{"name":"Clinica Chirurgica Generale Az. Ospedali Riuniti di Trieste, Trieste, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Terrosu","sequence":"additional","affiliation":[{"name":"Clinica Chirurgica, Az. Ospedaliera Universitaria S. Maria della Misericordia, Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Torricelli","sequence":"additional","affiliation":[{"name":"U.O. Chirurgia Generale Ospedale di Monfalcone, Gorizia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Stuto","sequence":"additional","affiliation":[{"name":"U.O. Chirurgia 2, Az. Ospedaliera S. Maria degli Angeli, Pordenone, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2013,1,20]]},"reference":[{"key":"bibr1-1553350612472988","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-004-0694-9"},{"key":"bibr2-1553350612472988","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2168.2002.02237.x"},{"key":"bibr3-1553350612472988","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-004-6502-8"},{"key":"bibr4-1553350612472988","doi-asserted-by":"publisher","DOI":"10.1080\/00015458.2005.11679665"},{"key":"bibr5-1553350612472988","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-006-0196-4"},{"key":"bibr6-1553350612472988","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-009-0750-y"},{"key":"bibr7-1553350612472988","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1318.2012.02965.x"},{"key":"bibr8-1553350612472988","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1318.2004.00590.x"},{"key":"bibr9-1553350612472988","first-page":"331","volume":"57","author":"Gaj F","year":"2002","journal-title":"Minerva Chir"},{"key":"bibr10-1553350612472988","first-page":"373","volume-title":"Coloproctology and the Pelvic Floor","author":"Thomson JPS","year":"1992"},{"key":"bibr11-1553350612472988","doi-asserted-by":"publisher","DOI":"10.1159\/000085343"},{"key":"bibr12-1553350612472988","volume-title":"Paper presented at: Proceedings of the 6th World Congress of Endoscopic Surgery","author":"Longo A"},{"key":"bibr13-1553350612472988","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-006-0852-3"},{"key":"bibr14-1553350612472988","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-005-0784-8"},{"key":"bibr15-1553350612472988","doi-asserted-by":"publisher","DOI":"10.1016\/S0399-8320(05)80798-5"}],"container-title":["Surgical Innovation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1553350612472988","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1553350612472988","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1553350612472988","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T07:17:43Z","timestamp":1777706263000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1553350612472988"}},"subtitle":["A Multicentric, Prospective, and Nonrandomized Trial"],"short-title":[],"issued":{"date-parts":[[2013,1,20]]},"references-count":15,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2013,12]]}},"alternative-id":["10.1177\/1553350612472988"],"URL":"https:\/\/doi.org\/10.1177\/1553350612472988","relation":{},"ISSN":["1553-3506","1553-3514"],"issn-type":[{"value":"1553-3506","type":"print"},{"value":"1553-3514","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,1,20]]}}}