Our Summary

This study compared two types of surgeries for hemorrhoids - the traditional method and a new technique called linear pinched hemorrhoidectomy (LPH). They looked at 215 patients with serious hemorrhoids, with 167 undergoing the traditional method and 48 undergoing LPH. They compared how long the patients stayed in hospital, how long the surgery took, how much blood was lost and any complications that arose.

Patients who underwent LPH were typically older. The study found that LPH had a few advantages over the traditional method - it required more removals, but the surgeries were quicker and involved less blood loss. There was also more use of anticoagulants, which help prevent blood clots. Both types of surgery had similar rates of complications. However, only the traditional surgery led to some patients having narrower anal passages and swelling of the wound.

The research concluded that LPH, which uses an ultrasonic scalpel (a device that uses sound waves to cut tissue) and a cylindrical proctoscope (a tool to view the rectum), is a useful procedure with few complications and is easy for medical trainees to learn. The researchers believe that as surgical tools continue to improve, surgeries for hemorrhoids will become safer and simpler.

FAQs

  1. What is linear pinched hemorrhoidectomy (LPH)?
  2. How does LPH differ from the traditional method of hemorrhoid surgery?
  3. What are the advantages of LPH over the traditional method of hemorrhoid surgery?

Doctor’s Tip

A doctor might advise a patient undergoing a hemorrhoidectomy to discuss with their surgeon the possibility of using the linear pinched hemorrhoidectomy (LPH) technique, as it may result in quicker surgery, less blood loss, and fewer complications compared to the traditional method. Additionally, the patient should inquire about the use of anticoagulants to prevent blood clots and follow post-operative care instructions carefully to promote healing and minimize the risk of complications such as narrowing of the anal passage.

Suitable For

Patients who are typically recommended for hemorrhoidectomy are those with serious hemorrhoids that have not responded to conservative treatment options such as dietary changes, stool softeners, and topical creams. Hemorrhoidectomy may be recommended for patients with large, painful, or prolapsed hemorrhoids that are causing significant discomfort and impacting their quality of life. It may also be recommended for patients who have recurrent hemorrhoids that do not improve with other treatments.

Timeline

Before undergoing hemorrhoidectomy, a patient may experience symptoms such as rectal bleeding, pain, itching, and discomfort. They may have tried conservative treatments such as fiber supplements, stool softeners, and topical creams without success.

After deciding to undergo hemorrhoidectomy, the patient will typically have a consultation with a surgeon to discuss the procedure and potential risks. They may be advised to stop taking certain medications and to follow specific pre-operative instructions.

During the surgery, the patient will be under anesthesia and the surgeon will remove the hemorrhoids using either the traditional method or a newer technique such as LPH. The surgery usually takes around 30-45 minutes.

After the surgery, the patient may experience pain, swelling, and discomfort in the anal area. They will be given pain medications and instructions on how to care for the surgical site. It is important to follow post-operative instructions carefully to promote healing and prevent complications.

In the weeks following the surgery, the patient will gradually recover and should see improvement in their symptoms. It is important to follow up with the surgeon for any concerns or complications that may arise.

Overall, hemorrhoidectomy can provide relief for patients with severe hemorrhoids, but it is important to weigh the risks and benefits of the procedure and to discuss any concerns with a healthcare provider.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with a hemorrhoidectomy?
  2. How long is the recovery period after a hemorrhoidectomy?
  3. Will I need to make any lifestyle changes or follow a specific diet after the surgery?
  4. How long will the surgery take?
  5. Will I need to stay in the hospital overnight after the surgery?
  6. What type of anesthesia will be used during the procedure?
  7. What is the success rate of this surgery in treating hemorrhoids?
  8. Are there any alternative treatments or procedures available for hemorrhoids?
  9. How soon after the surgery can I expect to see improvement in my symptoms?
  10. What post-operative care instructions should I follow to ensure a successful recovery?

Reference

Authors: Kurihara A, Yoshino Y, Sakai Y, Miura Y, Kagami S, Kaneko T, Ushigome M, Shiokawa H, Kaneko H, Funahashi K. Journal: J Anus Rectum Colon. 2021 Jul 29;5(3):261-267. doi: 10.23922/jarc.2020-076. eCollection 2021. PMID: 34395938