Our Summary

This study looked at tissue from nearly 2,000 surgeries to remove hemorrhoids, which are swollen veins in the rectum or anus. The researchers found that a very small percentage of these patients (0.21%) had a benign, or non-cancerous, skin condition known as melanocytic nevi (MN) in the anal canal. This condition is rare and there isn’t much data about how often it occurs.

MN were found in only one out of every 480 tissue specimens examined, and all were located in external hemorrhoids. The patients’ average age was 56.5 years, and the average size of the MN was 5.86 millimeters.

The researchers concluded that while MN are uncommon in hemorrhoidal tissue, it’s still important to routinely examine tissue from hemorrhoid removal surgeries. This can help detect whether the patient has benign or malignant (cancerous) tumors in the anal canal, which can easily be missed otherwise. The practice could also help detect other significant conditions early on.

FAQs

  1. What is the prevalence of melanocytic nevi (MN) in patients who undergo hemorrhoid removal surgeries?
  2. Where in the hemorrhoidal tissue were the melanocytic nevi typically found in the study?
  3. Why do researchers recommend routinely examining tissue from hemorrhoid removal surgeries?

Doctor’s Tip

One helpful tip a doctor might tell a patient about hemorrhoidectomy is to make sure to follow post-operative care instructions closely. This may include taking pain medication as prescribed, keeping the area clean and dry, and avoiding straining during bowel movements. It’s also important to follow up with your doctor for any concerns or complications that may arise during the healing process. Additionally, maintaining good hygiene and taking steps to prevent constipation can help reduce the risk of developing hemorrhoids in the future.

Suitable For

Hemorrhoidectomy is typically recommended for patients with severe or persistent symptoms of hemorrhoids that have not responded to conservative treatments such as dietary changes, topical medications, or minimally invasive procedures. Patients with large, painful, or thrombosed hemorrhoids, as well as those with recurrent hemorrhoids, may also be candidates for hemorrhoidectomy. Additionally, patients with complications of hemorrhoids such as chronic bleeding, prolapse, or strangulation may require surgical intervention. It is important for patients to discuss their symptoms and treatment options with a healthcare provider to determine if hemorrhoidectomy is the best course of action for their individual situation.

Timeline

Before hemorrhoidectomy:

  • Patient experiences symptoms of hemorrhoids such as pain, itching, swelling, and bleeding.
  • Patient may try conservative treatments such as dietary changes, topical creams, and sitz baths to manage symptoms.
  • If symptoms persist or worsen, patient may be referred to a surgeon for evaluation and possible surgical intervention.

After hemorrhoidectomy:

  • Patient undergoes surgery to remove hemorrhoids, either through traditional open surgery or minimally invasive techniques such as rubber band ligation or stapled hemorrhoidopexy.
  • Patient may experience pain, discomfort, and bleeding following surgery, which can be managed with pain medication and proper wound care.
  • Patient is advised to follow post-operative instructions, including dietary recommendations, proper hygiene practices, and activity restrictions.
  • Patient typically experiences relief from hemorrhoid symptoms and improved quality of life after recovery from surgery.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with a hemorrhoidectomy procedure?
  2. What is the expected recovery time and post-operative care plan?
  3. Are there any alternative treatments or procedures that could be considered?
  4. How many hemorrhoidectomy procedures have you performed, and what is your success rate?
  5. Will I need to follow any dietary or lifestyle changes before or after the surgery?
  6. How long will it take for me to see improvement in my symptoms following the procedure?
  7. Will I need any follow-up appointments or tests after the surgery?
  8. What can I do to prevent the recurrence of hemorrhoids in the future?
  9. Are there any specific warning signs or symptoms that I should watch out for after the surgery?
  10. Is there any specific information or research about melanocytic nevi in the anal canal that I should be aware of in relation to my hemorrhoidectomy procedure?

Reference

Authors: Val-Bernal JF, Mayorga M, Val D. Journal: Am J Dermatopathol. 2016 Apr;38(4):278-82. doi: 10.1097/DAD.0000000000000419. PMID: 26332535