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Perianal thrombosis: no need for surgery.
Ingo Alldinger1, Zoe Poschinski2, Silke Ganzera2
1Center of Coloproctology, Schadowstr. 11b, 40212, Düsseldorf, Germany. alldinger@cpz-duesseldorf.de.
Langenbeck'S Archives of Surgery
|January 22, 2022
Summary
Conservative treatment effectively resolves perianal thrombosis and thrombosed hemorrhoids. Most patients experience pain relief within 5 days and avoid sick leave, with a low recurrence rate, indicating surgery is unnecessary.
Area of Science:
- Proctology
- Surgical Gastroenterology
Background:
- Limited evidence exists for optimal perianal thrombosis treatment.
- Prospective trials are lacking, and retrospective data quality is often low.
Purpose of the Study:
- To evaluate the efficacy of conservative management for perianal thrombosis and thrombosed hemorrhoids.
- To assess pain levels, recovery time, and recurrence rates associated with non-surgical treatment.
Main Methods:
- A prospective study enrolled 619 patients with perianal thrombosis or thrombosed hemorrhoids.
- All patients received conservative treatment: sitz baths and oral pain medication.
- Data was retrospectively analyzed following prospective data collection via personal examination.
Main Results:
- 81.4% of patients (504) had perianal thrombosis; 18.6% (115) had thrombosed hemorrhoids.
- Mean pain scores were 3.8 for perianal thrombosis and 5.2 for thrombosed hemorrhoids.
- Pain resolved in 5 days, with complete resolution in 10 days. 88.5% did not require sick leave; recurrence was 6.3%.
Conclusions:
- Perianal thrombosis and thrombosed hemorrhoids demonstrate good healing outcomes with conservative therapy.
- Surgical intervention does not appear to offer advantages over non-surgical management for these conditions.
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