Skip to Main Content

++

Hemorrhoidectomy

++

  • Internal hemorrhoids: grade III and IV hemorrhoids, symptomatic combined internal and external hemorrhoids, bleeding, incarceration, or failure of conservative management.
  • External hemorrhoids: acute thrombosis < 72 hours post-onset.

++

Pilonidal Cyst Excision and Marsupialization

++

  • Recurrent acute pilonidal infections.
  • Chronic pilonidal sinus.

++

Anorectal Abscess and Fistula

++

  • Acute perirectal abscess.
  • Anorectal fistula.

++

Hemorrhoidectomy

++

Absolute

++

  • Anorectal Crohn's disease or Crohn's proctitis.
  • Acquired immunodeficiency syndrome.

++

Relative

++

  • Portal hypertension.
  • Pregnancy.
  • Coagulopathy.

++

Pilonidal Cyst Excision and Marsupialization

++

  • The presence of cancer requires additional treatment.

++

Anorectal Abscess and Fistula

++

  • Multiple fistulous tracts in a patient with Crohn's disease may require additional studies of the colon and sphincter mechanism prior to definitive surgical treatment.

++

Hemorrhoidectomy

++

  • The patient should be in the prone jackknife position with buttocks taped aside.
  • The procedure is performed under general anesthesia or intravenous sedation with local anesthesia.
  • Left anterolateral positioning and local anesthesia are suggested for pregnant patients.

++

Pilonidal Cyst Excision and Marsupialization

++

  • The patient should be in the prone jackknife position; lateral decubitus position may also be used.
  • The procedure may be performed under general anesthesia or local anesthesia with intravenous sedation.

++

Anorectal Abscess and Fistula

++

  • The patient should be in the prone jackknife position with buttocks taped aside.
  • The procedure is performed under general anesthesia, regional anesthesia, or intravenous sedation with local anesthesia.

++

Hemorrhoidectomy

++

  • Postoperative care includes analgesia, stool softeners, fiber supplementation, and sitz baths.

++

Pilonidal Cyst Excision and Marsupialization

++

  • Wound care includes daily showers or sitz baths, cleansing of wound, and removal of all hair within 3–4 cm of wound edges. The wound should be packed wet-to-dry with normal saline twice daily.

++

Anorectal Abscess and Fistula

++

  • Antibiotics are generally not indicted in healthy patients with a simple abscess. Antibiotics should be given for abscesses in patients with immunosuppression, diabetes, valvular heart disease or prosthetic valves, extensive soft tissue cellulitis, and signs of systemic infection or sepsis.
  • Wound care includes sitz baths twice daily and after bowel movements. Following abscess drainage, the cavity is lightly packed with a gauze tape.
  • Patients should receive adequate analgesia and stool softeners.

++

Hemorrhoidectomy

++

Early

++

  • Pain.
  • Urinary retention.
  • Bleeding.
  • Infection.
  • Fecal impaction.

++

Late

++

  • Anal stricture.
  • Anal tags.
  • Incontinence.
  • Mucosal prolapse.
  • Ectropion.

++

Pilonidal Cyst Excision and Marsupialization

++

  • Recurrent pilonidal sinus formation.
  • Infection.
  • Bleeding.
  • Delayed wound healing.

++

Anorectal Abscess Drainage

++

  • Incomplete drainage may lead to recurrent ...

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.

Ok

About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Subscription Options

AccessAnesthesiology Full Site: One-Year Subscription

Connect to the full suite of AccessAnesthesiology content and resources including procedural videos, interactive self-assessment, real-life cases, 20+ textbooks, and more

$995 USD
Buy Now

Pay Per View: Timed Access to all of AccessAnesthesiology

24 Hour Subscription $34.95

Buy Now

48 Hour Subscription $54.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.