J Korean Med Sci.  2014 Sep;29(9):1260-1265. 10.3346/jkms.2014.29.9.1260.

Results of Surgical Treatment on Benign Anal Diseases in Korean HIV-Positive Patients

• Oh HK
• Moon SH
• Ryoo S
• Choe EK
• Park KJ

• KMID: 1794605
• DOI: http://doi.org/10.3346/jkms.2014.29.9.1260

Abstract

Perianal diseases are the most common reasons for surgery in HIV-positive patients. This study aimed to evaluate the outcomes of these surgical procedures in Korean patients, focusing on wound healing and postoperative complications. Retrospective analysis was performed on 72 HIV-positive patients who underwent surgery by a single surgeon for benign anal disease between 1998 and 2011. Of these, 68.1% (49/72) of patients received surgery for condyloma acuminata, 19.4% (14/72) for anal fistulas, 6.9% (5/72) for hemorrhoids, and 5.6% (4/72) for perianal abscesses. Patients with condyloma acuminata received surgical excision with electrical coagulation, and all wounds healed completely within 3 months, though 16.3% (8/49) of these patients experienced recurrence. Twelve of the 49 patients (24.5%) who were treated for condyloma acuminata underwent simultaneous operations for concomitant anal fistulas (n = 6), hemorrhoids (n = 4), and perianal abscesses (n = 2). Overall, 3 postoperative complications developed following a total of 94 procedures, and there was no significant increase in complication rate for patients with a low CD4+ T-cell count ( < 200/microL) compared to those with a higher count. The results demonstrate favorable results following perianal surgery in HIV-positive Korean patients.

Keyword

HIV; Acquired Immunodeficiency Syndrome; Anal Operation; Condyloma Acuminata; Wound Healing

MeSH Terms

Adult
Aged
Anus Diseases/complications/*surgery
Asian Continental Ancestry Group
CD4-Positive T-Lymphocytes/cytology
Condylomata Acuminata/surgery
Female
HIV Infections/*complications
Hemorrhoids/surgery
Humans
Male
Middle Aged
Postoperative Complications
Rectal Fistula/surgery
Republic of Korea
Retrospective Studies
Treatment Outcome
Wound Healing
Young Adult

Figure

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  Fig. 1 Standard precautions were used when performing surgery on a patient positive for human immunodeficiency virus.

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  Fig. 2 Subtype of condyloma acuminata according to growth patterns. (A) Simple scattered type, and (B) Annular invasive type.

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  Fig. 3 Condyloma acuminata. (A) Preoperative status, (B) Immediate postoperative status after excision with electrocauterization, and (C) Healing wound one month after operation.

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