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Prospective survey of secondary bleeding following anorectal surgery in a consecutive series of 1,269 patients.
MedLine Citation:
PMID:  21055891     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
INTRODUCTION: As little data is available about secondary bleeding after proctological surgery, we conducted a specific survey.
PATIENTS AND METHODS: Patients operated between November 2008 and April 2009 were prospectively included. Patients were followed until last visit (day 21-28). Severity of bleeding was low (at home stay), moderate (hospitalisation for observation), or severe (transfusion, and/or homeostasis in operating room).
RESULTS: Included were 1269 patients: haemorrhoidectomy/pexy 527 (41%), fistula treatment 273 (21%), fissurectomy 197 (15%), perianal and pilonidal abscesses 124 (10%), others 148 (12%). Before surgery 78 patients were under long-term treatment with antiplatelet or anticoagulant therapy. Seventy-eight patients (6%) demonstrated 85 bleeding events. Severity rate was: low 22%, moderate 51%, and severe 27%. Ninety-five percent of events occurred before day 15. Univariate study showed increased risk after haemorrhoidopexy (P<10-3) and anticoagulant treatment (P = 0.002), decreased risk after fissurectomy and fistulotomy (P<10-3), and no relation with age, sex or operator. After multivariate study only relationship with anticoagulant treatment remained significant.
CONCLUSION: Secondary bleeding occurred in 6% of patients after proctological surgery, requiring a readmission and/or an active treatment in about 75%. Treatment with anticoagulant exposed to increased bleeding frequency.
Authors:
F Pigot; F Juguet; D Bouchard; A Castinel; J-P Vove
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinics and research in hepatology and gastroenterology     Volume:  35     ISSN:  2210-741X     ISO Abbreviation:  Clin Res Hepatol Gastroenterol     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-06-01     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101553659     Medline TA:  Clin Res Hepatol Gastroenterol     Country:  France    
Other Details:
Languages:  eng     Pagination:  41-7     Citation Subset:  IM    
Affiliation:
Hôpital Bagatelle, 201, rue Robespierre, 33401 Talence cedex, France. proctobagatelle@mspb.com
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