Hewitt W R, Sokol T P, Fleshner P R
Division of Colon and Rectal Surgery, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Dis Colon Rectum. 1996 Jun;39(6):615-8. doi: 10.1007/BF02056937.
There is a widespread belief that performing hemorrhoidectomy on a patient infected with human immunodeficiency virus (HIV) is an invitation for disaster. Aim of this study was to compare morbidity of hemorrhoidectomy in HIV-positive (HIV+) with HIV-negative (HIV-) patients.
Charts of 27 HIV+ and 30 HIV- male patients less than age 50 years who underwent hemorrhoidectomy were reviewed.
Mean age of the 57 study group patients was 38 years. Open hemorrhoidectomy was performed in 26 patients (46 percent), and a closed technique was used in 31 patients (54 percent). HIV+ and HIV- patient groups were well matched to all preoperative and intraoperative variables. Mean T-cell helper count in the HIV+ patient group was 301 (range, 9-1,040) cells/microliter. There were no deaths, and complications were seen in 15 patients (26 percent). There was no difference in overall complication rates between HIV+ and HIV- patient groups. Urinary retention was seen in ten patients (18 percent), three of whom were HIV+ (11 percent) vs. seven of whom were HIV- (23 percent) (P = not significant). Although no patient required reoperation for bleeding, postoperative hemorrhage was seen in three patients (1 HIV+, 2 HIV-). None of the patients developed fecal incontinence. Mean time to complete wound healing was 6.8 (range, 4-12) weeks for HIV+ patients vs. 6.6 (range, 4-14) weeks for HIV- patients (P = not significant).
These data suggest that HIV status of a patient should not alter indications for surgical management of hemorrhoidal disease.
人们普遍认为，对感染人类免疫缺陷病毒（HIV）的患者进行痔切除术会带来灾难。本研究的目的是比较HIV阳性（HIV+）患者与HIV阴性（HIV-）患者痔切除术的发病率。
回顾了27例年龄小于50岁接受痔切除术的HIV+男性患者和30例HIV-男性患者的病历。
57例研究组患者的平均年龄为38岁。26例患者（46%）采用开放式痔切除术，31例患者（54%）采用闭合式技术。HIV+和HIV-患者组在所有术前和术中变量方面匹配良好。HIV+患者组的平均辅助性T细胞计数为301（范围9-1040）个/微升。无死亡病例，15例患者（26%）出现并发症。HIV+和HIV-患者组的总体并发症发生率无差异。10例患者（18%）出现尿潴留，其中3例为HIV+（11%），7例为HIV-（23%）（P=无显著性差异）。虽然没有患者因出血需要再次手术，但3例患者（1例HIV+，2例HIV-）出现术后出血。没有患者出现大便失禁。HIV+患者伤口完全愈合的平均时间为6.8（范围4-12）周，HIV-患者为6.6（范围4-14）周（P=无显著性差异）。
这些数据表明，患者的HIV状态不应改变痔病手术治疗的指征。
