Thrombectomy combined with vein stripping: An alternative technique to treat thrombosed external hemorrhoid disease

Authors

  • Carlos Edmundo Martinez Jaramillo Hospital Militar Central https://orcid.org/0000-0002-4982-8955
  • Nairo Javier Senejoa Nuñez Hospital Militar Central https://orcid.org/0000-0002-9785-8534
  • Heinz Orlando Ibañez Varela Hospital Militar Central
  • Luis Franciso Miranda Clínica las Américas
  • Roberto Jose Rodriguez Florez Hospital Militar Central
  • Nicolás Betancur García Hospital Militar Central
  • Laura Daniela Ramirez Melo Universidad Militar Nueva Granada
  • Maria Camila Rubio Rubiano Universidad Militar Nueva Granada

DOI:

https://doi.org/10.22516/25007440.659

Keywords:

Hemorrhoids, Thrombectomy, Recurrence, Treatment, Outcome

Abstract

Objective: To evaluate the results of thrombectomy combined with vein stripping as an alternative to treat external thrombosed hemorrhoid disease.

Materials and methods: This is an observational, quantitative, retrospective, cross-sectional and descriptive study of the patients who underwent thrombectomy combined with vein stripping as an alternative technique to treat thrombosed external hemorrhoid disease at the Coloproctology Service of the Hospital Militar Central from January 1, 2014, to December 31, 2016.

Results: It was found that 197 patients consulted due to thrombosed external hemorrhoids. 71% were men.  The average age for the conservative treatment group vs. the surgical treatment group was 48.5 vs. 43.2 years, respectively. The average follow-up time after initiation of medical or surgical treatment was 16 months. In the surgical treatment group, the recurrence rate was 7.2% and the recurrence interval was 29.2 months.

Conclusions: Patients who underwent thrombectomy combined with vein stripping had a lower recurrence rate of thrombosed hemorrhoids, a lower pain score, and less postoperative bleeding. Hemorrhoid thrombectomy combined with vein stripping is a well-tolerated technique that can be performed at the doctor’s office without anesthesia, unlike the current management standard with external elliptical hemorrhoidectomy, which that requires local, regional, or general anesthesia, and a surgical room, leaving a larger skin defect following the resection of the tissue, with longer healing time and greater postoperative pain.

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Author Biographies

Carlos Edmundo Martinez Jaramillo, Hospital Militar Central

Médico cirujano general, Especialista en coloproctología. Bogotá, Colombia.

Nairo Javier Senejoa Nuñez, Hospital Militar Central

Médico cirujano especialista en coloproctología. Bogotá

Heinz Orlando Ibañez Varela, Hospital Militar Central

Médico cirujano especiista en coloproctología. Bogotá

Luis Franciso Miranda, Clínica las Américas

Cirujano general especialista en coloproctología. Medellín

Roberto Jose Rodriguez Florez, Hospital Militar Central

Cirujano general, fellow en coloproctología. Bogotá

Nicolás Betancur García, Hospital Militar Central

Médico cirujano general, fellow en coloproctología. Bogotá

Laura Daniela Ramirez Melo, Universidad Militar Nueva Granada

Estudiante de medicina, Hospital Militar Central. Bogotá

Maria Camila Rubio Rubiano, Universidad Militar Nueva Granada

Estudiante de medicina. Hospital militar central. Bogotá

References

Cintron J, Abcarian AM, Abcarian H, Makiewicz K, Brand MI. Hemorrhoids. En: Abcarian H, Cintron J, Nelson R (editores). Complications in anorectal surgery. Prevention and management. Springer; 2017. p. 61-108. https://doi.org/10.1007/978-3-319-48406-8_4

Sanchez C, Chinn BT. Hemorrhoids. Clin Colon Rectal Surg. 2011;24(1):5-13. https://doi.org/10.1055/s-0031-1272818

Thomson WH. The nature of haemorrhoids. Br J Surg. 1975;62(7):542-52. https://doi.org/10.1002/bjs.1800620710

Aigner F, Gruber H, Conrad F, Eder J, Wedel T, Zelger B, et al. Revised morphology and hemodynamics of the anorectal vascular plexus: impact on the course of hemorrhoidal disease. Int J Colorectal Dis. 2009;24(1):105-13. https://doi.org/10.1007/s00384-008-0572-3

Schubert MC, Sridhar S, Schade RR, Wexner SD. What every gastroenterologist needs to know about common anorectal disorders. World J Gastroenterol. 2009;15(26):3201-9. https://doi.org/10.3748/wjg.15.3201

Sun Z, Migaly J. Review of Hemorrhoid Disease: Presentation and Management. Clin Colon Rectal Surg. 2016;29(1):22-9. https://doi.org/10.1055/s-0035-1568144

Sneider EB, Maykel JA. Diagnosis and management of symptomatic hemorrhoids. Surg Clin North Am. 2010;90(1):17-32. https://doi.org/10.1016/j.suc.2009.10.005

Gençosmanoğlu R, Sad O, Koç D, Inceoğlu R. Hemorrhoidectomy: open or closed technique? A prospective, randomized clinical trial. Dis Colon Rectum. 2002;45(1):70-5. https://doi.org/10.1007/s10350-004-6116-1

Talley NJ, Lasch KL, Baum CL. A gap in our understanding: chronic constipation and its comorbid conditions. Clin Gastroenterol Hepatol. 2009;7(1):9-19. https://doi.org/10.1016/j.cgh.2008.07.005

Wronski K. Etiology of thrombosed external hemorrhoids. Postepy Hig Med Dosw (Online). 2012;66:41-4.

Mott T, Latimer K, Edwards C. Hemorrhoids: Diagnosis and Treatment Options. Am Fam Physician. 2018;97(3):172-179.

Margetis N. Pathophysiology of internal hemorrhoids. Ann Gastroenterol. 2019;32(3):264-272. https://doi.org/10.20524/aog.2019.0355

Greenspon J, Williams SB, Young HA, Orkin BA. Thrombosed external hemorrhoids: outcome after conservative or surgical management. Dis Colon Rectum. 2004;47(9):1493-8. https://doi.org/10.1007/s10350-004-0607-y

Abramowitz L, Sobhani I, Benifla JL, Vuagnat A, Daraï E, Mignon M, et al. Anal fissure and thrombosed external hemorrhoids before and after delivery. Dis Colon Rectum. 2002;45(5):650-5. https://doi.org/10.1007/s10350-004-6262-5

Gebbensleben O, Hilger Y, Rohde H. Do we at all need surgery to treat thrombosed external hemorrhoids? Results of a prospective cohort study. Clin Exp Gastroenterol. 2009;2:69-74. https://doi.org/10.2147/ceg.s5986

Janicke DM, Pundt MR. Anorectal disorders. Emerg Med Clin North Am. 1996;14(4):757-88. https://doi.org/10.1016/s0733-8627(05)70278-9

Cavcić J, Turcić J, Martinac P, Mestrović T, Mladina R, Pezerović-Panijan R. Comparison of topically applied 0.2% glyceryl trinitrate ointment, incision and excision in the treatment of perianal thrombosis. Dig Liver Dis. 2001;33(4):335-40. https://doi.org/10.1016/s1590-8658(01)80088-8

Perrotti P, Antropoli C, Molino D, De Stefano G, Antropoli M. Conservative treatment of acute thrombosed external hemorrhoids with topical nifedipine. Dis Colon Rectum. 2001;44(3):405-9. https://doi.org/10.1007/BF02234741

Figura 1. Técnica de trombectomía más fleboextracción

Published

2021-06-29

How to Cite

Martinez Jaramillo, C. E., Senejoa Nuñez, N. J. ., Ibañez Varela, H. O. ., Miranda, L. F., Rodriguez Florez, R. J., Betancur García, N., … Rubio Rubiano, M. C. . (2021). Thrombectomy combined with vein stripping: An alternative technique to treat thrombosed external hemorrhoid disease. Revista Colombiana De Gastroenterología, 36(2), 206–211. https://doi.org/10.22516/25007440.659

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