Ten-year multicentric retrospective analysis regarding postoperative complications and impact of comorbidities in hemorrhoidal surgery with literature review  

作　　者：Cosmin Moldovan Elena Rusu Daniel Cochior Madalina Elena Toba Horia Mocanu Razvan Adam Mirela Rimbu Adrian Ghenea Florin Savulescu Daniela Godoroja Florin Botea 

机构地区：[1]Department of Medical Surgical Disciplines,Faculty of Medicine,Titu Maiorescu University of Bucharest,Bucharest 031593,Romania [2]Department of General Surgery,Witting Clinical Hospital,Bucharest 010243,Romania [3]Department of Preclinic Disciplines,Faculty of Medicine,Titu Maiorescu University of Bucharest,Bucharest 031593,Romania [4]Department of General Surgery,Sanador Clinical Hospital,Bucharest 010991,Romania [5]Department of General Surgery,Monza Clinical Hospital,Bucharest 021967,Romania [6]Department of Ear,Nose and Throat,Ilfov County Clinical Emergency Hospital,Bucharest 022104,Romania [7]Department of Orthopedics and Traumatology,Elias Emergency University Hospital,Bucharest 011461,Romania [8]Medical Doctoral School,Titu Maiorescu University of Bucharest,Bucharest 040317,Romania [9]Department of Coloproctology,MedLife SA Băneasa Hyperclinic,Bucharest 013693,Romania [10]nd Department of Surgery,Carol Davila Central Military Emergency University Hospital,Bucharest 010242,Romania [11]Department of Anesthesia,Ponderas Academic Hospital,Bucharest 014142,Romania [12]Florin Botea,2nd Department of Surgery,Fundeni Clinical Institute,Bucharest 022328,Romania

出　　处：《World Journal of Clinical Cases》2023年第2期366-384,共19页世界临床病例杂志

摘　　要：BACKGROUND Hemorrhoidal disease(HD)is considered a low-severity pathology by both general population and physicians,but the lengthy conservative therapy and postoperative complications suggest otherwise.AIM To assess the effectiveness of different treatment options,both conservative and surgical,in contrast with some preexisting comorbidities.METHODS We conducted a retrospective,10-yearlong study between January 2011 and December 2021 in two surgical centers,a private and a state-owned hospital.We compared the efficacy and safety of several treatment options,such as open hemorrhoidectomy,stapled hemorrhoidopexy,rubber band ligation and infrared coagulation in terms of complication rates and types and their correlation with different preexisting comorbidities such as inflammatory bowel disease(IBD),use of anticoagulant medication(AM)and liver cirrhosis.We also conducted a 20-years long PubMed research(1.263 articles)for relevant comparisons.RESULTS Our study recorded 10940 patients with HD,10241 with conservative and 699 with surgical treatment.Out of these,the male-to-female ratio of 1.3,and a peak in age distribution between 59 and 68 years old(32%of patients).For the entire study,we recorded a 90%incidence of immediate pain,immediate bleeding in 1.5%(11 cases),delayed bleeding in 1.0%(7 cases),and 0.6%surgical site infections.Urinary retention was also present,with 0.2%of patients,anal stricture in 1%and fecal incontinence for 0.5%of patients(4 cases).We recorded no severe complications such as Fournier`s gangrene or rectovaginal perforations.IBD accounted for 6%of the patients,with ulcerative colitis in 12%and Chron`s disease in 10.5%.6.6%of the patients had AM,determining 4%immediate and 2%delayed bleeding,in surgically treated patients.CONCLUSION Our study determined that most common complications(pain,urinary retention,bleeding,and stricture)are correlated with each surgical technique and pre-existing comorbidities.

关 键 词：RETROSPECTIVE Hemorrhoidal POSTOPERATIVE COMPLICATIONS COMORBIDITIES 

分 类 号：R266[医药卫生—中医外科学]