IS SURGICAL TREATMENT OF COMPLICATED HEMORRHOIDS DURING PREGNANCY SAFE? A RETROSPECTIVE ANALYSIS OF 13 PATIENTS AND LITERATURE REVIEW
Journal Title: Çukurova Anestezi ve Cerrahi Bilimler Dergisi - Year 2019, Vol 2, Issue 1
Abstract
Aim: We reviewed the treatment outcomes of pregnant women who received surgical treatment at our center with the intention of assessing safety of surgical intervention for complicated hemorrhoids during pregnancy; a subject on which there is limited literature. Material and Methods: Records of the patients who received surgical treatment for hemorrhoids between January 2011 and April 2018 were retrospectively analyzed. The information of the patients who did not respond to medical and/or conservative management was recorded by taking the following parameters into account: age of the patient, month of pregnancy, history of hemorrhoids or anorectal surgery, presenting complaints, comorbidities, body mass index, previous medical treatment, physical examination, colonoscopy/rectoscopy results, co-existing anorectal disorders, the surgical procedures performed, complications, duration of the hospital stay, follow-up examination and the outcome of the surgical procedure performed. Results: Thirteen (17.8%) of the female patients who received surgical treatment were pregnant. Eight (61.5%) of the pregnant patients were in the third trimester, 4 (30.7%) were in the second trimester, while only 1 (7.6%) was in the first trimester. The most common presenting complaints were pain and per rectal bleeding. Mean age of the patients was 30 (20-40) years, whereas mean body mass index was 27 (23-36) kg/m2. Hemorrhoidectomy (Milligan-Morgan or Ferguson) was performed on 9 (69.2%), hemorrhoidectomy and sphincterotomy on 2 (15.3%) patients, hemorrhoidopexy on 1 (7.6%) patient while excision of thrombus was performed on 1 (7.6%) patient. Average length of the surgical procedure was 30 (10-35) minutes whereas the duration of the hospital stay was on average 2 (1-3) days. During the early postoperative period 11 (84.6%) patients complained of excessive pain while ileus was observed in 1 (7.6%) patient. Conclusion: Hemorrhoidal disease is quite common during pregnancy and medical/conservative treatment should be the first-line remedy. But for the patients presenting with acute hemorrhoidal disease, surgical intervention can be applied with minimal risk of complications atcenters with adequate surgical, anesthetic and technical capabilities
Authors and Affiliations
Hakan Yabanoğlu
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IS SURGICAL TREATMENT OF COMPLICATED HEMORRHOIDS DURING PREGNANCY SAFE? A RETROSPECTIVE ANALYSIS OF 13 PATIENTS AND LITERATURE REVIEW
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