Our Summary

This study compares two different types of surgeries to treat severe hemorrhoids: transanal hemorrhoidal artery ligation and conventional excisional hemorrhoidectomy. After looking at data from 1,681 patients over a two-year period, the researchers found that both types of surgery had similar results in terms of patient symptoms after surgery.

However, patients who had the conventional excisional hemorrhoidectomy were more likely to have complications after surgery. This risk was lower if the surgery was performed with newer surgical tools, compared to traditional ones.

On the other hand, patients who had the transanal hemorrhoidal artery ligation surgery were more likely to have their hemorrhoids come back. The type of surgical tool used didn’t affect this risk.

The researchers did highlight that the study has some limitations. It was retrospective, meaning it looked at past data, and the data was self-reported by different centers, which could introduce some bias.

In conclusion, both types of surgeries can effectively treat severe hemorrhoids. However, the artery ligation surgery might have a higher risk of the hemorrhoids coming back, while the conventional hemorrhoidectomy could lead to more post-surgery complications, especially if done with traditional tools.

FAQs

  1. What are the two types of surgeries discussed for treating severe hemorrhoids?
  2. What are the potential risks of conventional excisional hemorrhoidectomy and transanal hemorrhoidal artery ligation surgeries?
  3. Does the type of surgical tool used affect the risk of complications or recurrence of hemorrhoids?

Doctor’s Tip

Therefore, it is important for patients to discuss with their doctor the pros and cons of each type of surgery and to make an informed decision based on their individual situation. Additionally, following post-operative care instructions, such as taking prescribed medications, eating a high-fiber diet, staying hydrated, and avoiding straining during bowel movements, can help promote healing and reduce the risk of complications. Regular follow-up appointments with your doctor are also important to monitor your recovery progress.

Suitable For

Hemorrhoidectomy is typically recommended for patients with severe hemorrhoids that have not responded to conservative treatments such as dietary changes, topical medications, and lifestyle modifications. Patients who experience chronic pain, bleeding, prolapse, and other severe symptoms of hemorrhoids may be candidates for hemorrhoidectomy. It is important for patients to discuss their symptoms and treatment options with a healthcare provider to determine the best course of action for their individual situation.

Timeline

Before the hemorrhoidectomy:

  1. Patient experiences symptoms of hemorrhoids such as pain, bleeding, itching, and swelling.
  2. Patient consults with a healthcare provider who recommends surgery as a treatment option.
  3. Patient undergoes pre-operative evaluations and tests to determine the best surgical approach.
  4. Surgical date is scheduled, and patient receives instructions on how to prepare for the surgery.

After the hemorrhoidectomy:

  1. Patient undergoes the surgery, either transanal hemorrhoidal artery ligation or conventional excisional hemorrhoidectomy.
  2. Patient experiences post-operative pain, discomfort, and swelling, which are managed with pain medication and other treatments.
  3. Patient is monitored for any complications such as bleeding, infection, or urinary retention.
  4. Patient is discharged from the hospital and instructed on post-operative care, including diet, hygiene, and activity restrictions.
  5. Patient follows up with the healthcare provider for evaluation of surgical outcomes and management of any ongoing symptoms or complications.

What to Ask Your Doctor

Some questions a patient should ask their doctor about hemorrhoidectomy include:

  1. What are the potential risks and complications associated with each type of surgery (transanal hemorrhoidal artery ligation and conventional excisional hemorrhoidectomy)?
  2. How long is the recovery time for each type of surgery?
  3. Which type of surgery is recommended for my specific case of severe hemorrhoids?
  4. Are there any alternative treatments or non-surgical options that I should consider before opting for surgery?
  5. What can I expect in terms of pain management after the surgery?
  6. How likely is it that my hemorrhoids will come back after surgery?
  7. Are there any lifestyle changes or preventive measures I can take to reduce the risk of recurring hemorrhoids after surgery?
  8. How experienced are you in performing hemorrhoidectomies, and what is your success rate with this procedure?
  9. Can you provide me with information about the specific surgical tools and techniques you use for each type of surgery?
  10. Are there any specific instructions or precautions I should follow before and after the surgery to ensure a successful outcome?

Reference

Authors: Giuliani A, Romano L, Necozione S, Cofini V, Di Donato G, Schietroma M, Carlei F; EMODART3 Study Group. Journal: Dis Colon Rectum. 2023 Dec 1;66(12):e1254-e1263. doi: 10.1097/DCR.0000000000002885. Epub 2023 Aug 24. PMID: 37616177