Our Summary

This research paper is about a study done on pregnant patients who had external thrombosed hemorrhoids, a painful condition caused by blood clots in hemorrhoids. The researchers compared two treatments: a conservative method (likely medications and lifestyle changes) and a surgical approach known as Ligasure hemorrhoidectomy.

The study was done in China at a major referral center and included 94 pregnant patients who chose their preferred treatment. The researchers then compared how effective each treatment was in relieving symptoms, preventing the hemorrhoids from returning, and how satisfied the patients were with their chosen treatment.

The results showed that patients who opted for surgery experienced less pain after treatment, returned to their normal activities faster, and had a lower chance of the hemorrhoids coming back compared to those who chose the conservative treatment. They were also more satisfied with their treatment. Importantly, the surgery didn’t lead to any significant complications and didn’t pose a risk to the mothers or their babies.

However, the study does have some limitations. It was a retrospective study, meaning it looked at past data rather than conducting a new experiment, and it only included patients from one center. Also, the number of patients included was relatively small. Despite these limitations, the study suggests that the Ligasure hemorrhoidectomy could be a safe and effective treatment for thrombosed external hemorrhoids in pregnancy, offering quicker relief and better patient satisfaction than conservative treatments.

FAQs

  1. What are the two treatments compared in this research for treating external thrombosed hemorrhoids?
  2. What were the findings of the study regarding the effectiveness and patient satisfaction of Ligasure hemorrhoidectomy compared to conservative treatments?
  3. What were the limitations of the study conducted on pregnant patients with thrombosed external hemorrhoids?

Doctor’s Tip

A helpful tip a doctor might tell a patient about hemorrhoidectomy is to carefully follow post-operative instructions to ensure proper healing and minimize the risk of complications. This may include taking prescribed medications, keeping the area clean and dry, avoiding straining during bowel movements, eating a high-fiber diet, staying hydrated, and avoiding heavy lifting or strenuous activities. It is important to communicate any concerns or changes in symptoms to your healthcare provider to ensure optimal recovery.

Suitable For

Patients who typically undergo a hemorrhoidectomy are those with severe or recurring hemorrhoids that have not responded to non-surgical treatments such as medications, lifestyle changes, and topical creams. Hemorrhoidectomy may be recommended for patients with large internal hemorrhoids that prolapse or protrude outside the anus, causing significant discomfort, bleeding, and pain.

Individuals with thrombosed external hemorrhoids, like the pregnant patients in the study mentioned above, may also be candidates for hemorrhoidectomy if the condition is particularly painful and does not improve with conservative measures. Additionally, patients with chronic hemorrhoidal symptoms such as bleeding, itching, and difficulty with bowel movements may benefit from surgical intervention to alleviate their symptoms and improve their quality of life.

Ultimately, the decision to undergo a hemorrhoidectomy should be made in consultation with a healthcare provider who can assess the severity of the hemorrhoids, discuss treatment options, and determine the most appropriate course of action based on the individual patient’s needs and preferences.

Timeline

Before the hemorrhoidectomy:

  • Patient experiences symptoms such as pain, swelling, and discomfort in the anal area
  • Patient may try conservative treatments such as medications, dietary changes, and lifestyle modifications to manage the symptoms
  • If conservative treatments are not effective, patient may be recommended for a surgical procedure like hemorrhoidectomy

After the hemorrhoidectomy:

  • Patient undergoes the surgical procedure to remove the hemorrhoids
  • Following the procedure, patient may experience some pain, swelling, and discomfort in the anal area
  • Patient is given instructions on post-operative care, including pain management, hygiene, and diet restrictions
  • Patient may need to take time off work or limit physical activities during the recovery period
  • Over time, the symptoms improve, and the patient’s quality of life is expected to improve
  • Follow-up appointments may be scheduled to monitor the patient’s progress and address any concerns or complications that may arise.

What to Ask Your Doctor

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

  1. What are the risks and potential complications associated with hemorrhoidectomy surgery?
  2. How long is the recovery period after hemorrhoidectomy surgery?
  3. Will I need to make any lifestyle changes or follow a specific post-operative care routine?
  4. How effective is the Ligasure hemorrhoidectomy compared to other treatment options for hemorrhoids?
  5. Will I need to undergo any tests or evaluations before undergoing hemorrhoidectomy surgery?
  6. Are there any alternative treatments or less invasive procedures that I can consider?
  7. What can I expect in terms of pain management during and after the surgery?
  8. How likely are my hemorrhoids to return after undergoing hemorrhoidectomy surgery?
  9. How experienced are you in performing hemorrhoidectomy surgeries, and what is your success rate?
  10. Are there any specific instructions or precautions I should follow before the surgery to ensure the best outcome?

Reference

Authors: Luo H, He X, Wang M, Zheng X, Peng R, Wang C, Li Q, Yang B. Journal: BMC Surg. 2023 Jan 19;23(1):15. doi: 10.1186/s12893-023-01910-1. PMID: 36658522