Quality of life after stapler haemorrhoidectomy evaluated by SF-36 questionnaire

Abstract

Objective: Hemorrhoids are normal elements of the anal canal anatomy and they become symptomatic with potential factors such as gravity or strain. When symptomatic, hemorrhoidal disease can be costly measured in time away from productive activities. The aim of the study was to assess changes in the quality of life of patients after hemorrhoidectomy using Short Form-36. Material and Methods:Thirty patients, 24 male and 6 female (age 28 to 65), who were diagnosed with grade III and IV internal hemorrhoidal disease at the general surgery outpatient clinic and treated with stapled hemorrhoidectomy were enrolled in the study. They filled out Short Form-36 a week before surgery and four weeks after surgery. Post-Hoc tests were evaluated with Bonferroni correction after Kruskal Wallis analysis. Wilcoxon test, Student-t-test and Mann-Whitney U test were used for statistical analysis using SPSS 15.Results: Physical health (Physical functioning, Physical role restriction, Bodily pain) scores were significantly improved after surgery. Conclusion:Success of hemorrhoidectomy operations can be evaluated by postoperative recovery, incidence of complications or relapses. Quality of life questionnaires are another method to evaluate the success of the treatment from the patient's perspective.Key Words: Hemorrhoidectomy, quality of life, Short Form-36 INTRODUCTIONHemorrhoidal disease is a frequent disease of the anal canal.Hemorrhoids are important vascular cushions located in the anal canal as part of the normal anatomy. These cushions are composed of arteries, veins, smooth muscle fibers and connective tissue embedded in thickened submucosa (1).They are located in three main positions; left lateral, right anterior and right posterior. Internal hemorrhoids are located above the dentate line and external hemorrhoids are located in the distal part of the dentate line. The etiology is not clear, within some factors are gravity, straining, irregular bowel habits. Other causes are pregnancy, birth, spicy food, chronic cough, obesity, alcohol, benign prostate hyperplasia, cirrhosis, intra-abdominal tumors and some activities that require long periods of immobility (2, 3).Many surgical techniques are applied for the treatment of hemorrhoidal disease. It is widely accepted to treat grade 1 and 2 patients medically (diet and medication) and minor procedures (band ligation, sclerotherapy) and grade 3 and 4 patients with surgery (2, 4, 5).Currently stapled hemorrhoidopexy is the preferred technique by patients, due to decreased postoperative pain and other complications, and shorter length of hospital stay (6-8). The success and efficacy of hemorrhoidectomy procedures can be evaluated based on postoperative healing duration, complications and recurrence as well as questionnaires that reveal patient's perspective.Short Form-36 (SF-36) is distinguished from other scales (Nottingham Health Profile) by being a selfassessment scale that is easily filled by the patient in a short time, evaluating the positive sides of the health status as well a...

Quality of Life of Patients Before and After Hemorrhoid Surgery: A Single-Center Study in Vietnam

“…Notably, Rørvik's cross-sectional and cohort analysis using multiple QoL scales, including SF-12, SF-36, EuroQoL 5-dimensions 5-levels, and Short Health Scale for hemorrhoidal disease, revealed significant QoL enhancements, similar to the findings from Martinsons's randomized trial comparing conventional hemorrhoidectomy and stapled hemorrhoidopexy (31,32). Erdogdu's research further corroborates these results, with significant post-surgical improvements in physical health scores assessed by SF-36 (33). Garg's observational study using the WHOQOL-BREF highlighted improvements in physical and psychological well-being one month post-stapled hemorrhoidopexy, though social domains showed minimal change (16).…”

Influence of Bowel Habit and Hormonal Changes on the Development of Hemorrhoidal Disease During Pregnancy and the Postdelivery Period: A Prospective Cohort Study

“…As in our study, several studies have used the SF-36 questionnaire to assess improvement in this outcome after available treatments. 34,35 However, as far as we know, this is the first time that quality of life has been analyzed in pregnant women. Because the SF-36 assesses the non-disease-specific perception of quality of life, in our study we also used an ad hoc method to evaluate the specific impact of hemorrhoidal disease on quality of life by using a scale from 0 to 10.…”

A Randomized Clinical Trial of Laser Hemorrhoidoplasty vs Milligan and Morgan Hemorrhoidectomy

“…They demonstrated that physical health (physical functioning, physical role restriction, and bodily pain) scores significantly improved after surgery. 16 Bouchard et al in a multicenter trial followed patients who underwent hemorrhoidectomy for 1 year and reported that all physical and mental domains of quality of life significantly improved, and 88% of patients were satisfied or very satisfied by the surgery. [15][16][17][18] The common postoperative complications in laser surgeries include delayed bleeding, presence of urinary retention, painful defecation, fistula, acute infection fissure, anal stenosis, fecal incontinence, and postoperative thrombosis.…”

“…16 Bouchard et al in a multicenter trial followed patients who underwent hemorrhoidectomy for 1 year and reported that all physical and mental domains of quality of life significantly improved, and 88% of patients were satisfied or very satisfied by the surgery. [15][16][17][18] The common postoperative complications in laser surgeries include delayed bleeding, presence of urinary retention, painful defecation, fistula, acute infection fissure, anal stenosis, fecal incontinence, and postoperative thrombosis. None of mentioned complications were observed in any of our patients within 6 months after surgery.…”