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Preoperative bleeding requiring transfusion: An under-reported indication for hemorrhoidectomy.
Elizabeth D Krebs1, Aimee Y Zhang1, Taryn E Hassinger1
1Department of Surgery, The University of Virginia Health System, Charlottesville, Virginia, USA.
American Journal of Surgery
|January 15, 2020
Summary
Hemorrhoidal bleeding requiring transfusion, though rare, affects 7.3% of surgical patients. Anticoagulant or antiplatelet use increases transfusion risk in hemorrhoidectomy patients.
Area of Science:
- Gastroenterology
- Colorectal Surgery
Background:
- Hemorrhoids commonly cause minor gastrointestinal bleeding.
- Major hemorrhage requiring blood transfusion after hemorrhoidectomy is considered rare.
Purpose of the Study:
- To determine the prevalence of preoperative transfusion in patients undergoing surgical hemorrhoidectomy.
- To identify risk factors associated with transfusion in this patient population.
Main Methods:
- Retrospective review of 520 patients undergoing surgical hemorrhoidectomy from 2012-2017.
- Bivariate and multivariable analyses were performed to compare patients who required transfusion versus those who did not.
Main Results:
- 7.3% of patients experienced hemorrhoidal bleeding requiring transfusion.
- Use of anticoagulants or non-aspirin antiplatelet agents was significantly associated with transfusion (OR 3.08, p=0.03).
- Patients requiring transfusion underwent extensive preoperative workups.
Conclusions:
- Hemorrhoidal bleeding requiring transfusion is an under-reported complication.
- Increased recognition of this complication may lead to earlier surgical intervention and reduced diagnostic costs.
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