Whitehead hemorrhoidectomy in older patients

Abstract:

Used in the treatment of gross circumferential hemorrhoidal prolapse. Whitehead hemorrhoidectomy is technically more demanding and has slightly more complications than four-quadrant hemorrhoidectomy. The former, however, offers a radical cure and is the better operation whereas the latter is often associated with considerable remaining skin tags and areas of residual hemorrhoidal tissue. Following the Whitehead operation, we have observed fewer complications in older patients compared to younger patients. Case notes and follow-up data of all patients who underwent a Whitehead hemorrhoidectomy in the period October 1995 to November 1999 were reviewed, and clinical presentation and outcome were analyzed. The study group consisted of 11 patients (8 males, 3 females), of median age 58 years (range, 41–,75 years). The median operation time was 30 min (range, 15–40 min). The median hospital stay was 3 days (range, 2–15 days). There was only early and one late complication, both with minimal related morbidity. In both these patients, appropriate treatment resulted in complete recovery. All othera patients had an uneventful course with no residual symptoms at the last visit. Elderly patients may be less prone to developing significant sphicter spasm due to a generally more lax sphincter tone. Therefore, they may be at less risk of suture line ischemia, breakdown and stenosis.