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Severe Postoperative Bleeding After Stapled Hemorrhoidopexy: Incidence and Causes

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Severe postoperative bleeding (SPB) represents a major issue of stapled hemorrhoidopexy (SH). The aim of the study is to assess SPB events over last 6 years. This essay is a retrospective study of clinical records on SH patients over a 6-year period 2012–2018 in the First Affiliated Hospital of a university. SPB events and other serious complications are assessed. A total of 41 of 3350 SH patients experienced SPB events and 49 SPB episodes (98%, 49/50) occurred within 14 postoperative days. Of the 41 SPB patients, 37 were discharged, 28 were identified as anastomotic bleeding, and 34 had an average Hb decrease of 33.9 g/l (range, 5–90 g/l). Univariate and multivariate analyses show the statistical significance between the SPB events and variables of surgeon group (p = 0.017 < 0.05), constipation (p = 0.030 < 0.05) and incarcerated hemorrhoid (p = 0.015 < 0.05). No postoperative mortality, rectal perforation, extrarectal/abdominal hemorrhage, and severe pelvic infection have been reported. SPB’s incidence is 1.25% and usually occurs within 2 weeks after SH. Patients with incarcerated hemorrhoid or constipation are more prone to SPB events, and extensive surgical experience can significantly reduce SPB events.

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The raw data required to reproduce these findings cannot be shared at this time as the data also forms a part of an ongoing study.


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Authors and Affiliations



Renjie Shi conceived the original study and supervised its design and execution. Huabing Chen designed the original study and wrote the paper with the assistance from the other authors. Zaili Tang collected and analyzed the data. Zhousong Wu assisted in writing the paper.

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Correspondence to Renjie Shi.

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The authors declare that they have no conflict of interest.

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All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5). This research study was conducted retrospectively from data obtained for clinical purposes. We consulted extensively with the IRB of University of South China who determined that our study did not need ethical approval. An IRB official waiver of ethical approval was granted from the IRB of University of South China.

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Informed consent was obtained from all patients for being included in the study.

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Chen, H., Tang, Z., Wu, Z. et al. Severe Postoperative Bleeding After Stapled Hemorrhoidopexy: Incidence and Causes. Indian J Surg 83, 1223–1227 (2021).

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