J Korean Surg Soc.  2011 Dec;81(Suppl 1):S39-S42. 10.4174/jkss.2011.81.Suppl1.S39.

Edematous and painful external hemorrhoids following intersphincteric resection for low rectal cancer

• Leong QM
• Son DN
• Baek SJ
• Cho JS
• Amar A
• Kwak JM
• Kim SH

• KMID: 1445783
• DOI: http://doi.org/10.4174/jkss.2011.81.Suppl1.S39

Abstract

Intersphincteric resection (ISR) is the ultimate sphincter saving procedure for low rectal cancer. Hemorrhoids are a common benign condition. We present and discuss a case of ISR which developed painful edematous hemorrhoids after ISR. A 62-year-old female with low rectal cancer received neoadjuvant chemoradiotherapy with successful down staging of tumor before undergoing robot assisted ISR with coloanal hand-sewn anastomosis. She had pre-existing external hemorrhoids which were not excised. She developed painful and edematous external hemorrhoids 4 days after surgery. These were treated conservatively before discharge. Many colorectal surgeons performing ISR have experienced similar situations in their patients, but none have reported on this phenomenon. We discuss the possible factors that may contribute to this situation. A possible solution is prophylactic excision of the hemorrhoids during coloanal anastomosis. Painful hemorrhoids may occur after ISR and if managed conservatively, the outcome is skin tags.

Keyword

Hemorrhoids; Intersphincteric resection; Rectal neoplasms

MeSH Terms

Chemoradiotherapy
Female
Hemorrhoids
Humans
Middle Aged
Rectal Neoplasms
Skin