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Perianal thrombosis: no need for surgery

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Abstract

Aim

There is little evidence for the best therapy for perianal thrombosis. No prospective trials exist. Even quality of retrospective data is low, due to low patient numbers or vague follow-up data.

Patients and methods

Six hundred nineteen patients with thrombosis of internal or external hemorrhoids who presented in our clinic between March 2017 and August 2018 were enrolled in the study. All patients were treated conservatively, with sitz baths and oral pain medication, if needed. No surgery was performed. Follow-up data was obtained by personal examination. Data was gathered prospectively, and data analysis was retrospective.

Results

Five hundred four patients had perianal thrombosis (81.4%), and 115 patients had thrombosed hemorrhoids. Mean pain on a numerical rating scale (0–10) was 3.8 for perianal thrombosis and 5.2 for thrombosed hemorrhoids. Five hundred forty-eight patients (88.5%) did not need a sick leave. On follow-up, patients stated that their pain had largely resolved after 5 days and completely disappeared after 10 days. Local recurrence rate after perianal thrombosis was 6.3%.

Conclusion

Perianal thrombosis and thrombosed hemorrhoids heal well without surgery. There is no evidence for advantages surgical therapy could offer.

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Authors and Affiliations

  1. Center of Coloproctology, Schadowstr. 11b, 40212, Düsseldorf, Germany

    Ingo Alldinger, Zoe Poschinski, Silke Ganzera & Christian Helmes

Authors
  1. Ingo Alldinger
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  2. Zoe Poschinski
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  3. Silke Ganzera
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  4. Christian Helmes
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Contributions

I.A. and C.H. developed the idea. Z.P. and S. G. prepared the manuscript. All authors gathered the data, and finally read and approved the manuscript.

Corresponding author

Correspondence to Ingo Alldinger.

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Ethics approval

The study was conducted in full accordance to the Declaration of Helsinki 2013. Since patient treatment was not affected by the retrospective study, it was covered by the ethics approval of the local ethics committee and no individual ethical approval was necessary.

Conflict of interest

The authors declare no competing interests.

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Cite this article

Alldinger, I., Poschinski, Z., Ganzera, S. et al. Perianal thrombosis: no need for surgery. Langenbecks Arch Surg 407, 1251–1256 (2022). https://doi.org/10.1007/s00423-021-02415-2

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  • DOI: https://doi.org/10.1007/s00423-021-02415-2

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