Matsuda Hospital Colo-Proctological Institute, 753 Irino-cho, Nishi-ku, Hamamatsu, Shizuoka 432-8061, Japan.
Surg Today. 2009;39(10):866-9. doi: 10.1007/s00595-009-3971-3. Epub 2009 Sep 27.
Postoperative hemorrhage (PH) is rare, but it is widely recognized as a postoperative complication of a hemorrhoidectomy. The assessment of this complication may provide information which can be used to improve the clinical outcome of a patient who has undergone a hemorrhoidectomy.
Between January 2006 and December 2007, a total of 1294 patients with symptomatic hemorrhoids underwent a hemorrhoidectomy at our hospital. The patient records were retrospectively analyzed.
In this study, 23 patients had suffered from PH and had undergone a second operation (1.7%). The bleeding points were located as follows: 14 anterior,7 right laterally, 8 left laterally, and 2 posteriorly. Of these patients with early hemorrhage, 1 case was at the anterior, 1 was left lateral, and 2 were posterior. A significant correlation was observed between the period and the location of postoperative hemorrhage (P = 0.0023). From one to four piles were excised (1 in 264 patients, 2 in 240 patients, 3 in 702 patients, 4 in 88 patients). A significant correlation was also observed between the number of piles and the occurrence of PH (P = 0.032).
At the posterior wall, a late period hemorrhage is less likely to be found than an early period hemorrhage. It was found that the more piles that were excised, the greater the occurrence of PH.
术后出血(PH)虽罕见,但被广泛认为是痔切除术的术后并发症。对该并发症的评估可提供相关信息,有助于改善痔切除术患者的临床预后。
2006 年 1 月至 2007 年 12 月,我院共对 1294 例有症状的痔患者施行痔切除术。对患者的病历进行回顾性分析。
本研究中,23 例患者发生 PH 而行二次手术(1.7%)。出血部位如下:前位 14 例,侧位右 7 例,侧位左 8 例,后位 2 例。其中早期出血 1 例前位,1 例左侧,2 例后位。术后出血的时间和部位有显著相关性(P = 0.0023)。切除的痔数为 1 个(264 例患者中),2 个(240 例患者中),3 个(702 例患者中),4 个(88 例患者中)。切除痔的数量与 PH 的发生也有显著相关性(P = 0.032)。
在后壁,更不容易发现早期出血,而晚期出血则较少见。切除的痔越多,PH 的发生几率越大。