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Hemorrhoidectomy: Does Age Make a Difference?

Steven J Capece1, Charles J Browning1, Cesar A Barros de Sousa1

  • 1Lehigh Valley Health Network, Department of Surgery and Colorectal Surgery, Allentown, Pennsylvania.

Diseases of the Colon and Rectum
|February 26, 2024
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Summary

Younger patients with grade II or III hemorrhoids are more likely to opt for hemorrhoidectomy as initial treatment compared to older individuals. Treatment progression to hemorrhoidectomy showed no significant time differences based on age or hemorrhoid grade.

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Area of Science:

  • Colorectal Surgery
  • Gastroenterology
  • Surgical Outcomes

Background:

  • Symptomatic grade II and III hemorrhoids often necessitate multimodal treatment, potentially leading to surgical resection.
  • Patient age and overall health status significantly influence treatment decisions for hemorrhoids.

Purpose of the Study:

  • To evaluate treatment progression for symptomatic grade II or III hemorrhoids.
  • To determine the likelihood of hemorrhoidectomy based on patient age and the time from diagnosis to surgery.

Main Methods:

  • Retrospective cohort study of 961 patients (2015-2020) with grade II or III internal hemorrhoids.
  • Patients aged 18-75 were stratified into age groups (18-30, 31-50, 51-75) and analyzed for treatment choices.
  • Exclusion criteria included thrombosed hemorrhoids and surgical contraindications.

Main Results:

  • Patients with grade III hemorrhoids were more likely to undergo initial hemorrhoidectomy than those with grade II (27.6% vs 4.1%).
  • Younger age groups (18-30 and 31-50) were more inclined towards initial hemorrhoidectomy compared to the 51-75 age group (23.5%, 22% vs 12.8%).
  • No significant difference in time to hemorrhoidectomy was observed for patients progressing from non-surgical to surgical treatment, irrespective of age or hemorrhoid grade.

Conclusions:

  • Younger patients tend to select hemorrhoidectomy as their primary treatment for symptomatic hemorrhoids.
  • Study limitations include analysis focused solely on age groups and potential surgeon/patient biases influencing outcomes.