Rectal perforation caused by anal stricture after hemorrhoid treatment

The Complications of Hemorrhoidectomy From Patients' Perspective: A Qualitative Study

Background

Hemorrhoidectomy is a common general surgical procedure with numerous and intensive complications.

Objective

This study sought to investigate the complications of hemorrhoidectomy from the patients' perspective.

Methods

This qualitative study employed a phenomenological approach to explore the experiences of 27 patients with a history of hemorrhoidectomy. Convenience sampling was utilized initially, but purposive sampling was used as the investigation continued. All participants' statements were documented after obtaining informed consent and permission to record their experiences. Interviews were conducted until data saturation was achieved. The interview data was analyzed using content analysis, which involved the systematic extraction, interpretation, and reporting of the concepts and themes in the data.

Results

The study identified three main categories of complications: physical, psychological, and social. Additionally, 26 themes and 56 sub-themes were identified and defined under the main categories. Physical complications (PhCs) included nutritional problems, pain, sleep disturbances, physical weakness, bleeding, fecal incontinence, excretion problems, infection, fissures, anal prolapse, urinary retention, and disease recurrence. Psychological complications (PsCs) included fear, aversion, denial, isolation, depression, boredom, embarrassment, feeling defective, and dependency; Social complications (SCs) included secrecy, irritability, social withdrawal, and inability to perform social roles.

Conclusions

In addition to common PhCs such as pain and bleeding, patients with a history of hemorrhoidectomy face numerous PsCs and SCs that need to be communicated to the patient before deciding on this surgery. Furthermore, doctors should also consider special measures to manage these complications properly.

Laser hemorrhoidoplasty for hemorrhoidal disease: a systematic review and meta-analysis

Laser hemorrhoidoplasty (LHP) is known as a new minimally invasive and painless procedure for symptomatic hemorrhoids. However, Milligan-Morgan (MM) may offer the best result of long-term cure rates. In this study, we aim to compare the efficacy between LHP and MM for hemorrhoidal disease treatment. Using specific keywords, we comprehensively go through the potential articles on PubMed, Europe PMC, and Google Scholar sources until April 19, 2022. All published studies on LHP and MM hemorrhoidectomy were collected. Statistical analysis was done by using Review Manager 5.4 software. Twelve studies with a total of 1756 patients with hemorrhoid grades II-IV were included for the analysis. Our pooled analysis revealed that LHP was associated with shorter operative time (p < 0.00001), shorter length of hospital stay (p = 0.0005), lower risk of urinary retention (p = 0.005) and anal stenosis (p = 0.0004), and lower VAS 24-h post-operative (p < 0.00001) when compared with MM. However, LHP and MM did not differ in terms of recurrence rate (p = 0.70). LHP was superior to MM procedure in terms of shortening the recovery time and minimizing post-operative complications for patients with hemorrhoidal disease.