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Hemorrhoidectomy during pregnancy: risk or relief?
R G Saleeby1, L Rosen, J J Stasik
1Division of Colon and Rectal Surgery, Allentown Hospital-Lehigh Valley Hospital Center, Pennsylvania 18103.
Diseases of the Colon and Rectum
|March 11, 1991
Summary
Hemorrhoidectomy can safely treat acute hemorrhoidal crises in pregnant women when conservative treatments fail. This surgical intervention provided significant pain relief with no reported maternal or fetal complications in a selected group of patients.
Area of Science:
- Obstetrics and Gynecology
- Colorectal Surgery
Background:
- Acute hemorrhoidal crisis is a common concern during pregnancy.
- Surgical intervention for hemorrhoids in pregnant patients is often avoided due to potential risks to mother and fetus.
Purpose of the Study:
- To evaluate the safety and efficacy of hemorrhoidectomy in pregnant patients experiencing acute hemorrhoidal crisis.
- To assess maternal and fetal outcomes following surgical management of hemorrhoids during pregnancy.
Main Methods:
- A retrospective review of 25 pregnant women who underwent hemorrhoidectomy between July 1983 and July 1989.
- Procedures involved closed hemorrhoidectomy under local anesthesia, targeting only symptomatic disease.
- Patient data included trimester, parity, history of hemorrhoidal symptoms, surgical details, and post-operative outcomes.
Main Results:
- All 25 patients experienced immediate relief from intractable pain post-surgery.
- No maternal or fetal complications were recorded.
- Six patients (24%) required further treatment for anorectal disease during long-term follow-up (6 months to 6 years).
Conclusions:
- Hemorrhoidectomy is a safe and effective option for selected pregnant patients with severe hemorrhoidal disease unresponsive to medical therapy.
- The procedure offers significant pain relief with minimal risk to both mother and fetus.
- Careful patient selection and surgical technique are crucial for successful outcomes.