Top

BMC Surgery

Published in:

Open Access 01-12-2023 | Hemorrhoidectomy | Research

Comparision of Ligasure hemorrhoidectomy and conservative treatment for thrombosed external hemorrhoids (TEH) in pregnancy

Authors: Huihua Luo, Xiaojun He, Min Wang, Xiaosong Zheng, Rong Peng, Chenwei Wang, Qiu Li, Bolin Yang

Published in: BMC Surgery | Issue 1/2023

Abstract

Background

Ligasure hemorrhoidectomy for thrombosed external hemorrhoids in pregnancy has been rarely studied.

Objective

The purpose of this article is to study the efficacy and safety of Ligasure hemorrhoidectomy comparing with conservative treatment for thrombosed external hemorrhoids in pregnancy.

Design

This was a retrospective cohort study.

Setting

The patients were treated at a tertiary referral center in China.

Patients

94 pregnant patients hospitalized for thrombosed external hemorrhoids from September 2020 to December 2021.

Interventions

Ligasure hemorrhoidectomy treatment or conservative treatment according to the patient’s wishes.

Main outcome measures

Symptom relief, recurrence and satisfaction of thrombosed external hemorrhoids in pregnancy with different interventions.

Results

There were no differences between groups in maternal age, gestational age, body mass index, parity, constipation and a prior history of thrombosed external hemorrhoids. The pain scores were less in surgical group than in conservative group in post-treatment days 1 and 7. Time to return to normal activities was shorter in surgical group than in conservative group (6.51 vs. 13.52 days, P < 0.001). Post-treatment complications were mild in surgical group and there were no significant differences concerning the rate of abortion, preterm birth, cesarean delivery and weight of fetus. Recurrence rate was significantly lower in surgical group (8.57% vs. 30.43%, P = 0.017). The patient satisfaction scores were significantly higher in surgical group than in conservative group (Z = − 2.979, P = 0.003).

Limitations

This was a retrospective study with a limited number of patients, the data was obtained from only one center.

Conclusions

Comparing with conservative treatment, Ligasure hemorrhoidectomy for TEH in pregnancy results in more rapid pain relief, shorter time to return to normal activities, lower incidence of recurrence, and better patient satisfaction. This type of surgery has low and mild postoperative complications, is not attended by any risk to the mother or her fetus.

Picciariello A, Rinaldi M, Grossi U, Verre L, De Fazio M, Dezi A, Tomasicchio G, Altomare DF, Gallo G. Management and treatment of external hemorrhoidal thrombosis. Front Surg. 2022;9:898850. https://doi.org/10.3389/fsurg.2022.898850.CrossRef

Mirhaidari SJ, Porter JA, Slezak FA. Thrombosed external hemorrhoids in pregnancy: a retrospective review of outcomes. Int J Colorectal Dis. 2016;31(8):1557–9. https://doi.org/10.1007/s00384-016-2565-y.CrossRef

Selvaggi L, Sciaudone G, Canonico S, Selvaggi F, Pellino G. The management of acute hemorrhoidal disease. Rev Recent Clin Trials. 2021;16(1):91–5. https://doi.org/10.2174/1574887115666200330162537.CrossRef

Avsar AF, Keskin HL. Haemorrhoids during pregnancy. J Obstet Gynaecol. 2010;30(3):231–7. https://doi.org/10.3109/01443610903439242.CrossRef

Lohsiriwat V. Approach to hemorrhoids. Curr Gastroenterol Rep. 2013;15(7):332. https://doi.org/10.1007/s11894-013-0332-6.CrossRef

Saleeby RG Jr, Rosen L, Stasik JJ, Riether RD, Sheets J, Khubchandani IT. Hemorrhoidectomy during pregnancy: risk or relief? Dis Colon Rectum. 1991;34(3):260–1. https://doi.org/10.1007/BF02090166.CrossRef

Nienhuijs S, de Hingh I. Conventional versus LigaSure hemorrhoidectomy for patients with symptomatic Hemorrhoids. Cochrane Database Syst Rev. 2009;2009(1):CD006761. https://doi.org/10.1002/14651858.CD006761.pub2.CrossRef

Abramowitz L. Prise en charge de la maladie hémorroïdaire chez la femme enceinte [Management of hemorrhoid disease in the pregnant woman]. Gastroenterol Clin Biol. 2008;32(5 Pt 2):S210–4. https://doi.org/10.1016/j.gcb.2008.04.012.CrossRef

van Tol RR, Kleijnen J, Watson AJM, Jongen J, Altomare DF, Qvist N, Higuero T, Muris JWM, Breukink SO. European Society of ColoProctology: guideline for haemorrhoidal disease. Colorectal Dis. 2020;22(6):650–62. https://doi.org/10.1111/codi.14975.CrossRef

10.

Hoover K, Jenkins TR. Evaluation and management of adnexal mass in pregnancy. Am J Obstet Gynecol. 2011;205(2):97–102. https://doi.org/10.1016/j.ajog.2011.01.050.CrossRef

11.

Ball E, Waters N, Cooper N, Talati C, Mallick R, Rabas S, Mukherjee A, Sri Ranjan Y, Thaha M, Doodia R, Keedwell R, Madhra M, Kuruba N, Malhas R, Gaughan E, Tompsett K, Gibson H, Wright H, Gnanachandran C, Hookaway T, Baker C, Murali K, Jurkovic D, Amso N, Clark J, Thangaratinam S, Chalhoub T, Kaloo P, Saridogan E. Evidence-Based Guideline on Laparoscopy in Pregnancy: Commissioned by the British Society for Gynaecological Endoscopy (BSGE) Endorsed by the Royal College of Obstetricians & Gynaecologists (RCOG). Facts Views Vis Obgyn. 2019;11(1):5–25.

12.

Upadya M, Saneesh PJ. Anaesthesia for non-obstetric surgery during pregnancy. Indian J Anaesth. 2016;60(4):234–41. https://doi.org/10.4103/0019-5049.179445.CrossRef

13.

Parangi S, Levine D, Henry A, Isakovich N, Pories S. Surgical gastrointestinal disorders during pregnancy. Am J Surg. 2007;193(2):223–32. https://doi.org/10.1016/j.amjsurg.2006.04.021. (PMID: 17236852).CrossRef

14.

Shin GH, Toto EL, Schey R. Pregnancy and postpartum bowel changes: constipation and fecal incontinence. Am J Gastroenterol. 2015;110(4):521–9. https://doi.org/10.1038/ajg.2015.76.CrossRef

15.

Gallo G, Martellucci J, Sturiale A, Clerico G, Milito G, Marino F, Cocorullo G, Giordano P, Mistrangelo M, Trompetto M. Consensus statement of the Italian society of colorectal surgery (SICCR): management and treatment of hemorrhoidal disease. Tech Coloproctol. 2020;24(2):145–64. https://doi.org/10.1007/s10151-020-02149-1.CrossRef

Title: Comparision of Ligasure hemorrhoidectomy and conservative treatment for thrombosed external hemorrhoids (TEH) in pregnancy
Authors: Huihua Luo
Xiaojun He
Min Wang
Xiaosong Zheng
Rong Peng
Chenwei Wang
Qiu Li
Bolin Yang
Publication date: 01-12-2023
Publisher: BioMed Central
Keywords: Hemorrhoidectomy
Constipation
Hemorrhoids
Hemorrhoidectomy
Constipation
Published in: BMC Surgery / Issue 1/2023
Electronic ISSN: 1471-2482
DOI: https://doi.org/10.1186/s12893-023-01910-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Comparision of Ligasure hemorrhoidectomy and conservative treatment for thrombosed external hemorrhoids (TEH) in pregnancy

Abstract

Background

Objective

Design

Setting

Patients

Interventions

Main outcome measures

Results

Limitations

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Objective

Design

Setting

Patients

Interventions

Main outcome measures

Results

Limitations

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2023

Comparison of freehand technique and a novel laser-guiding navigation system in femoral neck-cannulated screw fixation: a randomized controlled trial

Computed tomography-based patient-specific cutting guides used for positioning of the femoral component of implants during unicompartmental knee arthroplasty: a cadaver study

1470 nm laser is better for prostate hyperplasia treatment with different volume size via transurethral enucleation

Effect of spinal-pelvic sagittal balance on the clinical outcomes after lumbar fusion surgery

Complications of preventive loop ileostomy versus colostomy: a meta-analysis, trial sequential analysis, and systematic review

Relative decline in serum albumin help to predict anastomotic leakage for female patients following sphincter-preserving rectal surgery