A Clinical Analysis of 429 Cases of Hemorrhoids

Jang, Tong Seog; Kim, Jae Jun

Abstract

The clinical analysis was made on 429 patients with hemorrhoids who have been dmitted and operated at the department of Surgery, Soonchunhyang University Hospital,from January, 1986 to December, 1995 and the statistical interpretation was made to get the interval changes between the 1st half of period (1986-1990) and the 2nd half of period (1991-1995). The results were as follows: 1) The average distribution rate of hemorrhoids among benign anal diseases including hemorrhoids, fistula in auto, fissure in auto, and perianal abscess in the past one decade was 44.9% and the rate of the 2nd half(49.2%) was higher than one of the 1st half(41.2%). 2) The sex ratio of male to female was 1.65: 1 and the peak incidence was at 30s in age. In the 2nd half period the number of female patients and patients in 20s & 30s of age decreased but the number of patients in 40s of age increased. 3) 27 Patients had one hemorrhoidectomy and 3 Patients, two hemorrhoidectomies before. The average interval inbetween two different hemorrhoidecomies was 11 years involving 8.5 years of the 1st half and 13.2 years of the 2nd half. 4) The frequent symptoms were mass(34.6%), pain(26.1%), and bleeding(25.1%) but there was no interval change between the 1st half and the 2nd half. 5) The patient was first seen between 1 and 5 years after symptom development with 30.1% in frequency and the patients in the 2nd half came to hospital sooner. 6) The ratio of internal, mixed, and external type was 60.9.34:5.1 and there was no interval change. 7) The predominant location of hemorrhoids were right posterior(38.5%), left lateral(33.6%), right anterior(29.8%) and left posterior(23.8%) and there was no interval change. 8) The third grade of hemorrhoids was most frequent(52.4%) with no interval change. 9) The most of patients were operated by semi-open hemorrhoidectomy with mainly modified Nesselrod method and the number of open hemorrhoidectomies in the 1st half was larger than in the 2nd half. The most common associated anal surgery with hectorrhoidectomy was lateral internal partial sphincterotomy. 10) The associated anal diseases with hemorrhoids were skin tag(11.6%), anal fistula(6.1%), anal fissure(5.4%), and anal polyp(5.1%) in the order of frequency. There was no interval change. 11) The most common method of anesthesia for hemorrhoidectomy was the caudal anewthesia(79.2%) but hemorrhoidectomy incidence under the local anesthesia was only 0.5%. There was no interval change. 12) The common post-hemorrhoidectomy complications were urinary retention(7.7%), edema(7.5%), and bleeding(2.6%) in the order of frequency with no interval change. 13) The duration of hospitalization was between 4 to 7 days(42%) and the mean time was 8.78 days. The number of patients of the 2nd half was smaller than the number of patients of the 1st half in 7 days of admission.