Sun XW, Xu JY, Zhu CZ, Li SJ, Jin LJ, Zhu ZD. Analysis of factors impacting postoperative pain and quality of life in patients with mixed hemorrhoids: A retrospective study. World J Gastrointest Surg 2024; 16(3): 731-739 [PMID: 38577073 DOI: 10.4240/wjgs.v16.i3.731]
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Xiao-Wen Sun, Chang-Zhen Zhu, Si-Jia Li, Lu-Jia Jin, Zhi-Dong Zhu, Department of Gastrointestinal Surgery, Tsinghua University Affiliated Beijing Tsinghua Changgeng Hospital, Beijing 102218, China
Jing-Yi Xu, Surgical Department, Tsinghua University Affiliated Beijing Tsinghua Changgeng Hospital, Beijing 102218, China
Co-first authors: Xiao-Wen Sun and Jing-Yi Xu.
Author contributions: Sun XW, Xu JY, and Zhu ZD proposed the concept of this study, Zhu CZ participated in the data collection work, and Sun XW and Xu JY drafted the initial draft; Li SJ and Jin LJ contributed to the formal analysis of this study, while Zhu ZD conducted guiding research, methodology, and visualization; Xu JY validated the study, and all authors participated in the study and jointly reviewed and edited the manuscript; Sun XW and Xu JY have made equal contributions to this work as co-first authors.
Institutional review board statement: This study has been reviewed and approved by the Medical Ethics Committee of Tsinghua University Affiliated Beijing Tsinghua Changgeng Hospital.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: We declare that there is no disclosure of any interest relationship.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Received: January 12, 2024 Peer-review started: January 12, 2024 First decision: January 31, 2024 Revised: February 5, 2024 Accepted: February 27, 2024 Article in press: February 27, 2024 Published online: March 27, 2024 Processing time: 70 Days and 7.5 Hours
ARTICLE HIGHLIGHTS
Research background
Hemorrhoids are a common chronic anorectal disease characterized by the formation of venous clusters in the lower part of the rectum. Mixed hemorrhoids, in particular, often cause recurrent bleeding and can lead to severe anemia, negatively impacting the patient's health. Surgical treatment, such as Milligan-Morgan hemorrhoidectomy, is often necessary. However, postoperative pain is a common concern for patients undergoing this procedure, which can cause anxiety and affect their quality of life (QoL).
Research motivation
This study provides valuable information on improving surgical outcomes and postoperative care for patients with mixed hemorrhoids.
Research objectives
This study aimed to assess the factors influencing pain scores and QoL in patients with mixed hemorrhoids post-surgery.
Research methods
This retrospective study collected clinical data from patients with mixed hemorrhoids who underwent Milligan-Morgan hemorrhoidectomy. The basic characteristics of the enrolled patients with mixed hemorrhoids were recorded, and based on the Goligher clinical grading system, the hemorrhoids were classified as grades III or IV.
Research results
The results showed a significant reduction in postoperative pain over time, with some patients experiencing complete pain relief at 14 d and none reporting any pain at 28 d after surgery. Comparing the QoL scores between 14 and 28 d post-surgery, significant improvements were observed in various domains including overall QoL, health condition, physical health, psychological health, social relations, and surrounding environment. Milligan-Morgan hemorrhoidectomy was found to significantly improve the postoperative QoL for patients.
Research conclusions
Milligan-Morgan hemorrhoidectomy offers a promising approach for alleviating the negative impact of mixed hemorrhoids on patients' health and QoL.
Research perspectives
Several perspectives can be considered for future studies on mixed hemorrhoids and Milligan-Morgan hemorrhoidectomy. Firstly, further investigations could focus on optimizing pain management strategies post-surgery to minimize discomfort and anxiety in patients. Exploring alternative analgesic approaches or combination therapies may contribute to even better pain relief outcomes. Secondly, the impact of Milligan-Morgan hemorrhoidectomy on long-term QoL could be explored to assess whether the observed improvements are sustained over an extended period. Longitudinal studies could provide valuable insights into the durability of the procedure's benefits. Additionally, future research could delve deeper into the specific factors that influence the outcomes of Milligan-Morgan hemorrhoidectomy, such as age, sex, and the number of surgical resections. Understanding how these variables interact and affect surgical success could aid in tailoring treatment strategies for individual patients. Lastly, comparative studies could be conducted to evaluate the effectiveness and safety of Milligan-Morgan hemorrhoidectomy in comparison to other surgical techniques or emerging minimally invasive procedures. Such comparative analyses would help guide clinical decision-making and provide a comprehensive understanding of the available treatment options for mixed hemorrhoids. Overall, these research perspectives aim to further enhance the surgical management and overall well-being of patients with mixed hemorrhoids.
