ANALYSIS OF THE RESULTS OF ONE THOUSAND HEMORRHOIDECTOMIES PERFORMED AT A UNIVERSITY HOSPITAL

Introduction Hemorrhoidal disease has a high prevalence in the global population. Hemorrhoids are characterized by vascular structures in the anal canal, originating from the distal prolapse of arteriovenous connective tissue that drains into the superior and inferior hemorrhoidal veins. They can be classified as internal, external, and mixed, based on their location relative to the pectinate line. Internal hemorrhoids are further classified into grades I, II, III, and IV, depending on the degree of prolapse of the anal canal. Treatment ranges from behavioral modifications to surgical approaches. The two main types of conventional hemorrhoidectomy are closed hemorrhoidectomy (Ferguson) and open hemorrhoidectomy (Milligan-Morgan).

Objective To describe the results of one thousand consecutive hemorrhoidectomies performed at a university hospital.

Methods A retrospective study based on the analysis of electronic medical records of all patients who underwent hemorrhoidectomy from January 1991 to April 2024. The variables included were: age, sex, surgical technique, length of hospital stay, and complications associated with the surgery.

Results A total of 1,012 patients were operated on during the analyzed period. Of these, 984 patients (97.2%) underwent the Milligan-Morgan technique, and 14 patients (1.3%) underwent the Ferguson technique. Regarding sex, 513 men (50.6%) and 499 women (49.3%) were operated on. The average age of the patients was 45.79 years. The average length of hospitalization was 1.02 days. Regarding the classification of hemorrhoids, 651 were grade III, 191 were mixed, 129 were grade IV, and 41 were grade II. Of the total number of patients operated on, 53 (5.2%) experienced complications in the immediate postoperative period: 23 had urinary retention, 22 had postoperative bleeding, 5 had hemorrhoidal thrombosis, 2 had perianal abscesses, and 1 had a urinary infection. Four patients developed stenosis after healing.

Conclusion Based on the observed results, surgical excision of hemorrhoids is an effective approach, especially for more advanced cases and those with an external component. Despite the advent of new techniques, the Milligan-Morgan procedure is still predominant at the institution analyzed in this study. The complication rates are low, with the most common being minor bleeding and urinary retention.

No conflict of interest has been declared by the author(s).

Publication History

Article published online:
25 April 2025