Increased Long-term Risk of Anal Fistula After Proctologic Surgery: A Case-Control Study

Assaraf, Julie; Lambrescak, Elsa; Lefèvre, Jérémie H.; Parades, Vincent de; Bourguignon, Josée; Etienney, Isabelle; Taouk, Milad; Atienza, Patrick; Zeitoun, Jean–David

doi:10.3393/ac.2019.06.18

Cited by 2 publications

(2 citation statements)

References 14 publications

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“…A medical history of prior proctological surgery did not seem to be a risk factor of postoperative bleeding in our study. Little is known about this issue and the medical literature has little data although one recent study suggested that previous history of anal surgery was highly associated with the risk of anal fistula [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Frequency and risk factors of severe postoperative bleeding after proctological surgery: a retrospective case-control study

et al. 2022

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The aim of this study was to assess frequency and risk factors of severe bleeding after proctological surgery requiring hemostatic surgery observed after publication of the French guidelines for anticoagulant and platelet-inhibitor treatment. Methods: All patients who underwent proctological surgery between January 2012 and March 2017 in a referral center were included. Delay, severity of bleeding, and need for blood transfusion were recorded. Patients with severe postoperative bleeding were matched to controls at a 2:1 ratio adjusted on the operator, and the type of surgery. Results: Among the 8,890 operated patients, 65 (0.7%) needed a postoperative hemostatic procedure in an operating room. The risk of a hemostatic surgery was significantly increased after hemorrhoidal surgery compared with other procedures (1.9% vs. 0.5%, P < 10 -4 ) and was most frequent after Milligan-Morgan hemorrhoidectomy (2.5%). Mean bleeding time was 6.2 days and no bleeding occurred after day 15. Blood transfusion rate was 0.1%. Treatment with anticoagulants and platelet inhibitors were managed according to recommendations and did not increase the severity of bleeding. The risk of severe bleeding was significantly lower in active smokers vs. non-smokers in univariate (16.9% vs. 36.2%, P = 0.007) and multivariate (odds ratio, 0.31; 95% confidence interval, 0.14-0.65) analysis whereas sex, age, and body mass were not significantly associated with bleeding. Conclusion: Severe postoperative bleeding occurs in 0.7% of patients, but varies with type of procedure and is not affected by anticoagulant or antiplatelet treatment. These treatments given in accordance with the new guidelines do not increase the severity of postoperative bleeding.

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Section: Discussionmentioning

confidence: 99%

Frequency and risk factors of severe postoperative bleeding after proctological surgery: a retrospective case-control study

et al. 2022

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“…If possible, surgical procedures should be delayed until a few weeks after delivery. It would be advantageous to avoid potential complications associated with hemorrhoidectomy [18,19].…”

Section: Conservative Treatmentmentioning

confidence: 99%

Treatment of Hemorrhoid in Unusual Condition-Pregnancy

Ryu¹

2022

Ewha Med J

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Hemorrhoids are varicose veins of the rectum that are located in or near the anal canal and are covered by mucosa. They can occur at any age, are generally symptomless, and affect both sexes equally. Hemorrhoids are a common complaint among younger women and are more likely to occur during pregnancy and the menstrual cycle. In this article, we discuss the many approaches in the treatment of hemorrhoids. Laxatives, stool softeners, and fiber supplements are all considered safe for use by pregnant women. Moderate use of laxatives is also acceptable. Since there is a lack of sufficient evidence to support the safety and efficiency of topical medicines or oral phlebotomies during pregnancy, these treatments must to be utilized with an increased degree of extreme caution. In the case that considerable bleeding occurs, anal packing may be a straight forward and helpful operation to implement. A hemorhoidectomy is the treatment option for hemorrhoids that have become strangulated, badly thrombosed, or have bleeding that cannot be controlled. Incidence or Pathogenesis of Hemorrhoidal Disaease in PregnancyHemorrhoidal disease is often symptomatic and bothersome for pregnant women. It affects 25-35 percent of pregnant women [10], primarily presents in the third trimester, and can be

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Increased Long-term Risk of Anal Fistula After Proctologic Surgery: A Case-Control Study

Cited by 2 publications

References 14 publications

Frequency and risk factors of severe postoperative bleeding after proctological surgery: a retrospective case-control study

Frequency and risk factors of severe postoperative bleeding after proctological surgery: a retrospective case-control study

Treatment of Hemorrhoid in Unusual Condition-Pregnancy

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