Excision of Thrombosed External Hemorrhoid Under Local Anesthesia

Abstract

PURPOSE: This study was a retrospective analysis of complication rates, symptom recurrence, long-term results, and patient satisfaction after outpatient excision (local anesthesia) of thrombosed external hemorrhoids. METHODS: From 1995 to 2000, 340 patients (166 males) underwent office-based excision of thrombosed external hemorrhoids under local anesthesia. Data regarding complications, operations because of recurrence, residual symptoms, patient’s satisfaction with anesthesia, and wound treatment were obtained by questionnaire. Response was solicited at a minimum of 9 months postprocedure. RESULTS: Complete follow-up data was available in 88 percent of patients (mean follow-up, 17.3 months). Recurrent thrombosed external hemorrhoid requiring a procedure developed in 22 (6.5 percent) patients. Other complications that required operative intervention were one (0.3 percent) incidence of postoperative bleeding and seven (2.1 percent) perianal abscess/fistula. The majority of patients (66 percent) had no anal complaints at follow-up. Local anesthesia would be preferred if a repeat excision was required in 79 percent, whereas 11 percent would prefer another form of anesthesia and 10 percent were unsure. CONCLUSION: Outpatient excision under local anesthesia of a thrombosed external hemorrhoid can be safely performed with a low recurrence and complication rate while offering a high level of patient of acceptance and satisfaction.