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Should HIV status alter indications for hemorrhoidectomy?
W R Hewitt1, T P Sokol, P R Fleshner
1Division of Colon and Rectal Surgery, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Diseases of the Colon and Rectum
|June 1, 1996
Summary
Hemorrhoidectomy is safe for patients with human immunodeficiency virus (HIV). A study found no significant difference in complication rates or wound healing times between HIV-positive and HIV-negative patients undergoing the procedure.
Area of Science:
- Colorectal Surgery
- Infectious Diseases
- Surgical Outcomes
Background:
- Hemorrhoidectomy is a common surgical procedure.
- Concerns exist regarding the safety of hemorrhoidectomy in human immunodeficiency virus (HIV)-positive patients.
- Limited comparative data exists on surgical morbidity in HIV-positive versus HIV-negative individuals.
Purpose of the Study:
- To compare the morbidity associated with hemorrhoidectomy in HIV-positive (HIV+) patients versus HIV-negative (HIV-) patients.
- To evaluate potential differences in complication rates and wound healing.
- To inform surgical decision-making for hemorrhoidal disease in the context of HIV status.
Main Methods:
- Retrospective chart review of 27 HIV+ and 30 HIV- male patients under 50 years old who underwent hemorrhoidectomy.
- Analysis of preoperative and intraoperative variables, complication rates, and wound healing times.
- Matching of HIV+ and HIV- groups for key patient characteristics.
Main Results:
- No significant difference in overall complication rates between HIV+ and HIV- groups (26% overall).
- Similar rates of urinary retention and postoperative hemorrhage between groups.
- Comparable mean times to complete wound healing (6.8 weeks for HIV+ vs. 6.6 weeks for HIV-).
Conclusions:
- HIV status does not appear to be a contraindication for hemorrhoidectomy.
- Surgical management of hemorrhoidal disease should not be altered based solely on HIV status.
- Further research may explore specific management strategies if indicated.