Revista Brasileira de Coloproctologia
versão impressa ISSN 0101-9880
CRUZ, Geraldo Magela Gomes da et al. Hemorrhoidectomy: 2417 operated patients for hemorrhoidal disease treatment. Rev bras. colo-proctol. [online]. 2006, vol.26, n.3, pp. 253-268. ISSN 0101-9880. http://dx.doi.org/10.1590/S0101-98802006000300005.
The author had the opportunity in a 38-year period of practice in Coloproctology, to attend 34,000 patients. Diagnose of hemorrhoid as the main cause of the symptoms presented was achieved in 9,289 patients (27.3%). 2,417 of the 9,289 patients (26.0%) underwent hemorroidectomy. The aim of this report is to analyse 2,417 operated patients as far as epidemiologic aspects are concerned (age and gender), surgical procedures (table operative position, anesthesy, surgical techniques, associated anorectal diseases as well as surgical complications). Results are correlated to the literature. Most of the patients submitted to hemorrhoidectomy presented third (30.5%) and fourth grade (60.2%) hemorrhoid. As far as gender is concerned the incidence of hemorrhoid was statistically significant higher among women (5,007 cases, 53.9%) than in men (4,282 cases, 46.1%). And although not statistically significant surgery for hemorrhoid in women (1,330 : 5,007) was more common (26.6%) than in men (1,087 : 4,282) (25.4%). But in relation to the patients who underwent hemorrhoidectomy (2,417) surgery was statistically significant more common among women (1,330 : 2,417 or 55.0%) than in men (1,087 : 2,417 or 45.0%). Mean age of the patients by occasion of diagnose of hemorrhoids was 39.9 year-old, being 74.8% between 21 and 50 year of age; and mean age by occasion of surgery was 41.6 year-old, being 71.8% between 21 and 50 year of age. In 1,122 patients haemohrroids were associated with several anorectal diseases (12.1%), mainly anal fissures (5.8%) and hyperthrofied anal papila (3.4%). The incidence of surgery for associated anorectal disease was 13.1% (729 patients), being fissurectomy (13.1%) and papilectomy (11.0%) the two most frequently surgery carried out during hemorrhoidal approach. 45 patients (1.9%) were operated for other extra-anal diseases, mainly gynecologic surgery; and 26 patients (2.0%) presented systemic diseases and physiologic conditions as pregnancy (8 cases, 0,3%). The most frequently used anesthesia was peridural (42.3%) and local associated to analgesia (34.9%). Sim's (58.4%) and knife-position (40.1%) were the on table most used operative positions, being open haemorrhoidectomy (2,014 cases, 83.3%) the most frequently used surgical technique. There were 76 cases of surgical complications (3.1%) being anal stricture (40 cases, 1.8%) and postoperative bleeding (21 cases, 0,9%) the two most common complications.
Palavras-chave : Hemorrhoidectomy; and surgery; hemorrhoidal disease surgical treatment.