Excision of Thrombosed External Hemorrhoid Under Local Anesthesia

Jongen, Johannes; Bach, Sebastian; Stübinger, Sven Henrik; Bock, J.-U.

doi:10.1007/s10350-004-6719-6

Cited by 66 publications

(45 citation statements)

References 16 publications

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“…No difference in symptoms after 1 month was reported [80]. 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 [81].…”

Section: Surgical Treatmentmentioning

confidence: 98%

Evaluation and management of hemorrhoids: Italian society of colorectal surgery (SICCR) consensus statement

Trompetto¹,

Clerico²,

Cocorullo

et al. 2015

Tech Coloproctol

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Hemorrhoids are one of the most common medical and surgical diseases and the main reason for a visit to a coloproctologist. This consensus statement was drawn up by the Italian society of colorectal surgery in order to provide practice parameters for an accurate assessment of the disease and consequent appropriate treatment. The authors made a careful search in the main databases (MEDLINE, PubMed, Embase and Cochrane), and all results were classified on the basis of the grade of recommendation (A-C) of the American College of Chest Physicians.

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Section: Surgical Treatmentmentioning

confidence: 98%

Evaluation and management of hemorrhoids: Italian society of colorectal surgery (SICCR) consensus statement

Trompetto¹,

Clerico²,

Cocorullo

et al. 2015

Tech Coloproctol

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“…Complications, such as skin tags, early recurrence (3.1-6.5%), and delayed wound healing [(anal fissures, anal fistulas, or abscesses) (2.1-3.0%)], are often observed with early surgical intervention 105,106,109,110) .…”

Section: ) Thrombosed External Hemorrhoidsmentioning

confidence: 99%

Japanese Practice Guidelines for Anal Disorders I. Hemorrhoids

Yamana

2017

J Anus Rectum Colon

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The pathogenesis of hemorrhoids is a weakening of the anal cushion and spasm of the internal sphincter. Bowel habits and lifestyles can be risk factors for hemorrhoids. The prevalence of hemorrhoids can encompass 4 to 55% of the population. Symptoms include bleeding, pain, prolapsing, swelling, itching, and mucus soiling. The diagnosis of hemorrhoids requires taking a thorough history and conducting an anorectal examination. Goligher's classification, which indicates the degree of prolapsing with internal hemorrhoids, is useful for choosing treatment. Drug therapy for hemorrhoids is typically utilized for bleeding, pain, and swelling. Ligation and excision (LE) is considered for Grade III and IV internal and external hemorrhoids. Rubber band ligation is used to treat up to Grade III internal hemorrhoids. Phenol almond oil is effective for internal hemorrhoids up to Grade III, while aluminum potassium sulfate and tannic acid have shown efficacy in treating prolapsing in internal hemorrhoids at Grades II, III, and IV. Procedure for prolapse and hemorrhoids (PPH) is surgically effective for Grade III internal hemorrhoids; however, the long-term prognosis is not favorable, with high recurrence rates. Separating ligation is effective surgical treatment for internal/external hemorrhoids Grade III and Grade IV. The basic approach to thrombosed external hemorrhoids and incarcerated hemorrhoids is conservative treatment; however, in some acute or severe cases, surgical resection is considered. Comparing the different instruments used for hemorrhoid surgery, all reduce operating time, blood loss, post-operative pain, and length of time until the return to normal activity. They do, of course, increase the cost of the procedure.

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“…Our study is small in patient numbers compared to others 8,20,27 but has two advantages: data were gathered prospectively, and follow up period was short for all patients: six months (median, range: 2-13 months) with no range extending up to 4, 8 5, 20 or 12 27 years. Disadvantages are: results were obtained by questionnaire only as with others 20 due to the German insurance system which does not allow to see referred patients for follow-up, and regrettably only two thirds of is surgery the gold standard for therapy of thrombosed external hemorrhoids?…”

Section: Discussionmentioning

confidence: 94%

“…2,7,[15][16][17]20,21 Is this necessary? Only a minority of such patients present with formidable swelling, fierce bleeding, and overwhelming pain.…”

Section: Dovepressmentioning

confidence: 99%

“…Because swelling vanishes, a thrombus must not perforate anal skin, which means no bleeding, and may disappear within two to three weeks by resorption. There are no randomized controlled trials comparing surgical and conservative management of THE, 7,15,16,20 but surgical management is the gold standard 10,20,22 if the condition is encountered within the first 72 hours after onset 3,23 or fails to respond to conservative treatment. 2,8,18 What happens when a strict conservative management is started with painkillers, a wait-and-see policy, and dry anal cleaning after motions 24,25 independent of stage of TEH at presentation?…”

Section: Dovepressmentioning

confidence: 99%

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Do we at all need surgery to treat thrombosed external hemorrhoids? Results of a prospective cohort study

Gebbensleben

Hilger²,

Rohde³

2009

CEG

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Background: It is unknown whether surgery is the gold standard for therapy of thrombosed external hemorrhoids (TEH). Methods: A prospective cohort study of 72 adults with TEH was conducted: no surgery, no sitz baths but gentle dry cleaning with smooth toilet paper after defecation. Follow-up information was collected six months after admission by questionnaire. Results: Despite our strict conservative management policy 62.5% (45/72) of patients (95% confidence interval [CI]: 51.0-74.0) described themselves as "healed" or "ameliorated", and 61.1% (44/72, 95% CI: 49.6-72.6) found our management policy as "valuable to test" or "impracticable". 13.9% (10/72, 95% CI: 5.7-22.1) of patients suspected to have recurrences. 4.2% did not know. Twenty-two of the 48 responding patients reported symptoms such as itching (18.8%), soiling (12.5%), pricking (10.4%), or a sore bottom (8.3%) once a month (59.1%, 13/22), once a week (27.3%, 6/22), or every day (13.6%, 3/22). Conclusions:The dictum that surgery is the gold standard for therapy for TEH should be checked by randomized controlled trials.

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Excision of Thrombosed External Hemorrhoid Under Local Anesthesia

Abstract: 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.

Cited by 66 publications

References 16 publications

Evaluation and management of hemorrhoids: Italian society of colorectal surgery (SICCR) consensus statement

Evaluation and management of hemorrhoids: Italian society of colorectal surgery (SICCR) consensus statement

Japanese Practice Guidelines for Anal Disorders I. Hemorrhoids

Do we at all need surgery to treat thrombosed external hemorrhoids? Results of a prospective cohort study

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