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The necessity of preoperative enema preparation for hemorrhoidal surgery: a single-center comparative study

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Abstract

Background

Hemorrhoidal surgery is a common treatment for high-grade hemorrhoids. The necessity of preoperative enema preparation (PEP) in hemorrhoidal surgery is inconclusive. This study aims to evaluate the benefit and safety of PEP in hemorrhoidal surgery.

Methods

This comparative study analyzed data from electronic medical record database and outpatient questionnaire archive. Data of patients who underwent hemorrhoidal surgery from March 2020 to February 2021 were obtained. Patients were allocated to either the PEP or non-PEP group. Primary outcome measurements were postoperative pain and oral analgesic use. Secondary outcomes were the number of days until first defecation, length of hospital stay, time to return to work, incidence of urinary retention, delayed bleeding, and local infection.

Results

Data of 270 consecutive patients, with 130 and 140 in the PEP and non-PEP groups, respectively, who underwent hemorrhoidal surgery were analyzed. Most patients underwent stapled hemorrhoidopexy, with 106 (81.54%) in PEP group and 113 (80.71%) in non-PEP group. The mean pain score was significantly higher in PEP than in non-PEP group at day 0 (6.21 ± 3.23 vs 5.31 ± 3.14), day 1 (5.79 ± 2.89 vs 4.68 ± 3.02), and day 2 (5.35 ± 2.86 vs 4.42 ± 2.76). No significant differences in postoperative recovery or complications rate were noted between groups.

Conclusion

Our findings revealed that performing PEP before hemorrhoidal surgery produced no benefit when compared with not performing PEP. Typically, the procedure of PEP is inconvenient and discomforting for patients. Therefore, we suggest that it can be omitted in hemorrhoidal surgery.

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Data availability

The datasets used for this study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Department of General Medicine, Chi Mei Medical Center, No.901, Zhonghua Rd. Yongkang Dist, Tainan City, 71004, Taiwan

    Po-Chung Lin

  2. Division of Colorectal Surgery, Department of Surgery, Shuang Ho Hospital, Taipei Medical University, Number 291, Zhongzheng Road, Zhonghe District, New Taipei City, 235, Taiwan

    Min-Hsuan Yen, Kee-Thai Kiu & Tung-Cheng Chang

  3. Biostatistics Center, Office of Data Science, Taipei Medical University, No.172-1, Sec. 2, Keelung Rd, Taipei City, 106, Taiwan

    Yu-Chun Yen

  4. Division of General Surgery, Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Number 291, Zhongzheng Road, Zhonghe District, New Taipei City, 235, Taiwan

    Ka-Wai Tam

  5. Division of General Surgery, Department of Surgery, Shuang Ho Hospital, Taipei Medical University, Number 291, Zhongzheng Road, Zhonghe District, New Taipei City, 235, Taiwan

    Ka-Wai Tam

  6. Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan

    Ka-Wai Tam

  7. Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan

    Tung-Cheng Chang

Authors
  1. Po-Chung Lin
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  2. Min-Hsuan Yen
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Contributions

Conception and design: Ka-Wai Tam and Tung-Cheng Chang. Data acquisition: Po-Chung Lin, Min-Hsuan Yen, Kee-Thai Kiu, and Tung-Cheng Chang. Data analysis and interpretation: Po-Chung Lin, Yu-Chun Yen, Ka-Wai Tam, and Tung-Cheng Chang. Manuscript writing, review, and revision: Po-Chung Lin, Ka-Wai Tam and Tung-Cheng Chang.

Corresponding author

Correspondence to Tung-Cheng Chang.

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The authors declare no competing interests.

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Supplementary Information

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423_2022_2587_MOESM1_ESM.docx

Appendix 1. The questionnaire provided to patients to assess daily pain score, analgesics use, defecation frequency, and days until return to work. Supplementary file1 (DOCX 17 KB)

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Lin, PC., Yen, MH., Kiu, KT. et al. The necessity of preoperative enema preparation for hemorrhoidal surgery: a single-center comparative study. Langenbecks Arch Surg 407, 3005–3012 (2022). https://doi.org/10.1007/s00423-022-02587-5

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  • DOI: https://doi.org/10.1007/s00423-022-02587-5

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