Comment je fais pour… traiter une hémorragie après chirurgie hémorroïdaire ?

How do I treat… a haemorrhage following haemorrhoid surgery?

Résumé

Quelle que soit la technique chirurgicale utilisée pour traiter la maladie hémorroïdaire, une hémorragie postopératoire peut survenir de façon précoce ou tardive. La fréquence des hémorragies au cours des 24 premières heures est identique quelle que soit la technique utilisée, alors qu’au-delà cette complication concerne davantage l’hémorroïdectomie pédiculaire; la fréquence des hospitalisations et le taux de recours á la chirurgie sont toutefois similaires. L’hémorragie postopératoire peut céder spontanément, mais lorsqu’elle est active, la mise en oeuvre précoce d’un traitement adapté au lit du malade ou au bloc opératoire évitera des transfusions sanguines inutiles.

Abstract

Whatever the technique chosen to treat haemorrhoidal disease, postoperative haemorrhage can take place in both early and late postoperative periods. Haemorrhage frequency during the first 24 hours is the same whatever technique is used, whereas after this period, the complication arises more frequently for peduncular haemorrhoidectomy, rehospitalisation and reoperation rates, however, remaining similar. Postoperative haemorrhage can stop spontaneously but when it does not early treatment is required, sometimes in the operating theatre, in order to avoid unnecessary blood transfusions.

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Références

  1. 1.

    Chen HH, Wang JY, Changchien CR, et al. (2002) Risk factors associated with posthemorrhoidectomy secondary hemorrhage: a single-institution prospective study of 4,880 consecutive closed hemorrhoidectomies. Dis Colon Rectum 45: 1096–1099

    PubMed  Article  Google Scholar 

  2. 2.

    Tjandra JJ, Chan MK (2007) Systematic review on the procedure for prolapse and hemorrhoids (stapled hemorrhoidopexy). Dis Colon Rectum 50: 878–892

    PubMed  Article  Google Scholar 

  3. 3.

    Nisar PJ, Acheson AG, Neal KR, Scholefield JH (2004) Stapled hemorrhoidopexy compared with conventional hemorrhoidectomy: systematic review of randomized, controlled trials. Dis Colon Rectum 47: 1837–1845

    PubMed  Article  Google Scholar 

  4. 4.

    Chen HH, Wang JY, Changchien CR, et al. (2002) Effective management of posthemorrhoidectomy secondary hemorrhage using rectal irrigation. Dis Colon Rectum 45: 234–238

    PubMed  Article  Google Scholar 

  5. 5.

    Abramowitz L, Godeberge P, Staumont G, Soudan D (2001) Clinical practice guidelines for the treatment of hemorrhoid disease. Gastroenterol Clin Biol Jun 25: 674–702

    CAS  Google Scholar 

  6. 6.

    La Torre F, Nicolai AP (2004) Clinical use of micronized purified flavonoid fraction for treatment of symptoms after hemorrhoidectomy: results of a randomized, controlled, clinical trial. Dis Colon Rectum 47: 704–710

    PubMed  Article  Google Scholar 

  7. 7.

    Mongardini M, Custureri F, Schillaci F, et al. (2005) Prevention of postoperative pain and haemorrhage in PPH (Procedure for Prolapse and Hemorrhoids) and STARR (Stapled Trans-Anal Rectal Resection). Preliminary results in 261 cases. G Chir 26: 157–161

    PubMed  CAS  Google Scholar 

  8. 8.

    Arroyo A, Perez-Vicente F, Miranda E, et al. (2006) Prospective randomized clinical trial comparing two different circular staplers for mucosectomy in the treatment of hemorrhoids. World J Surg 30: 1305–1310

    PubMed  Article  Google Scholar 

  9. 9.

    Cirocco WC, Golub RW (1995) Local epinephrine injection as treatment for delayed hemorrhage after hemorrhoidectomy. Surgery 117: 235–237

    PubMed  Article  CAS  Google Scholar 

  10. 10.

    Basso L, Pescatori M (1994) Outcome of delayed hemorrhage following surgical hemorrhoidectomy. Dis Colon Rectum 37: 288–289

    PubMed  Article  CAS  Google Scholar 

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Correspondence to A. Senéjoux.

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Senéjoux, A. Comment je fais pour… traiter une hémorragie après chirurgie hémorroïdaire ?. Colon Rectum 1, 260–262 (2007). https://doi.org/10.1007/s11725-007-0052-x

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Mots clés

  • Hémorroïdectomie
  • Anopexie
  • Hémorragie postopératoire

Keywords

  • Haemorrhoidectomy
  • Anopexy
  • Postoperative haemorrhage