Modified whitehead hemorrhoidectomy versus partial hemorrhoidectomy for fourth-degree circular mixed hemorrhoids: A retrospective analysis

作者全名：Liu, Xie; Sheng, Bo; Zhang, Jianbo; Wang, Jijian; Yu, Jun; Zhang, Guanggang; Dai, Fengshun; Su, Heng; Xu, Jingsong; Hu, Wei; Li, Tong; Zhu, Peng

作者地址：[Liu, Xie; Sheng, Bo; Zhang, Jianbo; Wang, Jijian; Yu, Jun; Li, Tong; Zhu, Peng] Chongqing Med Univ, Affiliated Hosp 2, Dept Gastrointestinal Surg, 76 Linjiang Rd, Chongqing 400010, Peoples R China; [Zhang, Guanggang] Peoples Hosp Chongqing City, Dept Gen Surg, Chongqing 400014, Peoples R China; [Dai, Fengshun; Su, Heng; Xu, Jingsong; Hu, Wei] Renmin Hosp Wushan Cty, Dept Gen Surg, Chongqing 404700, Peoples R China

通信作者：Li, T; Zhu, P (通讯作者)，Chongqing Med Univ, Affiliated Hosp 2, Dept Gastrointestinal Surg, 76 Linjiang Rd, Chongqing 400010, Peoples R China.

来源：HELIYON

ESI学科分类：　

WOS号：WOS:001221195200001

JCR分区：Q1

影响因子：3.4

年份：2024

卷号：10

期号：7

开始页：　

结束页：　

文献类型：Article

关键词：Hemorrhoid; Whitehead hemorrhoidectomy; Anal stricture; Mucosal ectroption

摘要：Background: Grade IV circular hemorrhoids are difficult to treat. We aim to describe the modified whitehead hemorrhoidectomy procedure and to assess the effectiveness and safety of this procedure for grade IV circular hemorrhoid patients. Methods: Patients with grade IV circular hemorrhoids who underwent modified Whitehead hemorrhoidectomy and partial hemorrhoidectomy for fourth-degree circular mixed hemorrhoids were retrospectively reviewed. Clinical data were extracted from the database at our institution, and long-term postoperative complications were assessed through repeated outpatient examinations and telephonic communication. Results: A total of 205 patients were included in this study. The mean operative time was 59.2 +/- 13.8 min. The average hospital stay was 4.6 +/- 1.0 days. For postoperative complications, 66 (32.2%) patients had urinary retention, 10 (4.9%) patients had a sense of incomplete rectal emptying, 5 (2.4%) patients had anal incontinence, and 6 (2.9%) patients had wound infection. For long-term postoperative complications, 3 (1.5%) patients experienced mild to moderate anal stricture, 2 (1%) patients experienced mucosal ectropion, they all had smooth recoveries, and none of them needed secondary surgery. None of these patients had a hemorrhoid recurrence. A total of 205 patients who received modified Whitehead hemorrhoidectomy and 161 who received partial hemorrhoidectomy were included. There were no residual hemorrhoids in patients who received modified Whitehead hemorrhoidectomy, and none had hemorrhoid recurrence. Fiftyeight patients who received partial hemorrhoidectomy had hemorrhoidal residues, and 19 patients experienced hemorrhoid recurrence. After modified Whitehead hemorrhoidectomy, 3 patients developed anal stenosis, and 2 had mucosal ectropion. Four patients developed anal stricture after partial hemorrhoidectomy, and none had mucosal ectropion. They all had smooth recoveries, and none of them needed a secondary surgery. For the mean duration of surgery, postoperative bleeding, postoperative pain, wound infection, sense of incomplete rectal emptying, anal incontinence, and urinary retention, no statistically significant differences were found between the two groups. Conclusions: Compared with partial hemorrhoidectomy, modified whitehead hemorrhoidectomy is an effective and safe surgical procedure and does not significantly increase the risk of anal stenosis and mucosal ectropion for grade IV circular hemorrhoid patients. Prospective random- ized controlled trials are needed to verify our results.

基金机构：Science and Health Joint Project of Chongqing, China [2020MSXM052]

基金资助正文：This study is funded by the Science and Health Joint Project of Chongqing, China (NO. 2020MSXM052) .