Jongen Johannes, Bach Sebastian, Stübinger Sven Henrik, Bock Jens-Uwe
Proctological Office and Department of Surgical Proctology, Park-Klinik, Kiel, Germany.
Dis Colon Rectum. 2003 Sep;46(9):1226-31. doi: 10.1007/s10350-004-6719-6.
This study was a retrospective analysis of complication rates, symptom recurrence, long-term results, and patient satisfaction after outpatient excision (local anesthesia) of thrombosed external hemorrhoids.
From 1995 to 2000, 340 patients (166 males) underwent office-based excision of thrombosed external hemorrhoids under local anesthesia. Data regarding complications, operations because of recurrence, residual symptoms, patient's satisfaction with anesthesia, and wound treatment were obtained by questionnaire. Response was solicited at a minimum of 9 months postprocedure.
Complete follow-up data was available in 88 percent of patients (mean follow-up, 17.3 months). Recurrent thrombosed external hemorrhoid requiring a procedure developed in 22 (6.5 percent) patients. Other complications that required operative intervention were one (0.3 percent) incidence of postoperative bleeding and seven (2.1 percent) perianal abscess/fistula. The majority of patients (66 percent) had no anal complaints at follow-up. Local anesthesia would be preferred if a repeat excision was required in 79 percent, whereas 11 percent would prefer another form of anesthesia and 10 percent were unsure.
Outpatient excision under local anesthesia of a thrombosed external hemorrhoid can be safely performed with a low recurrence and complication rate while offering a high level of patient of acceptance and satisfaction.
本研究是对门诊切除（局部麻醉）血栓性外痔后的并发症发生率、症状复发情况、长期结果及患者满意度进行的回顾性分析。
1995年至2000年，340例患者（166例男性）在局部麻醉下于门诊接受血栓性外痔切除术。通过问卷调查获取有关并发症、因复发而进行的手术、残留症状、患者对麻醉的满意度及伤口处理的数据。术后至少9个月进行随访。
88%的患者有完整的随访数据（平均随访时间为17.3个月）。22例（6.5%）患者出现复发性血栓性外痔，需要再次手术。其他需要手术干预的并发症包括1例（0.3%）术后出血和7例（2.1%）肛周脓肿/肛瘘。大多数患者（66%）在随访时无肛门不适。如果需要再次切除，79%的患者更倾向于局部麻醉，11%的患者更倾向于其他麻醉方式，10%的患者不确定。
局部麻醉下门诊切除血栓性外痔可安全进行，复发率和并发症发生率低，患者接受度和满意度高。
