대한대장항문학회

The clinical analysis was made on 429 patients with hemorrhoids who have been<br>admitted and operated at the department of Surgery, Soonchunhyang University Hospital,<br>from January, 1986 to December, 1995 and the statistical interpretation was made to get<br>the interval changes between the 1st half of period (1986-1990) and the 2nd half of<br>period (1991-1995). The results were as follows:<br>1) The average distribution rate of hemorrhoids among benign anal diseases including<br>hemorrhoids, fistula in auto, fissure in auto, and perianal abscess in the past one decade<br>was 44.9% and the rate of the 2nd half(49.2%) was higher than one of the 1st<br>half(41.2% ).<br>2) The sex ratio of male to female was 1.65: 1 and the peak incidence was at 30s in<br>age.<br>In the 2nd half period the number of female patients and patients in 20s & 30s of age<br>decreased but the number of patients in 40s of age increased.<br>3) 27 Patients had one hemorrhoidectomy and 3 Patients, two hemorrhoidectomies<br>before.<br>The average interval inbetween two different hemorrhoidecomies was 11 years<br>involving 8.5 years of the 1st half and 13.2 years of the 2nd half.<br>4) The frequent symptoms were mass(34.6%), pain(26.1%), and bleeding(25.1%) but<br>there was no interval change between the 1st half and the 2nd half.<br>5) The patient was first seen between 1 and 5 years after symptom development with<br>30.1% in frequency and the patients in the 2nd half came to hospital sooner.<br>6) The ratio of internal, mixed, and external type was 60.9.34:5.1 and there was no<br>in- terval change.<br>7) The predominant location of hemorrhoids were right posterior(38.5%), left<br>lateral(33.6%), right anterior(29.8%) and left posterior(23.8%) and there was no interval<br>change.<br>8) The third grade of hemorrhoids was most frequent(52.4%) with no interval change.<br>9) The most of patients were operated by semi-open hemorrhoidectomy with mainly<br>modified Nesselrod method and the number of open hemorrhoidectomies in the 1st half<br>was larger than in the 2nd half. The most common associated anal surgery with hector-<br>rhoidectomy was lateral internal partial sphincterotomy.<br>10) The associated anal diseases with hemorrhoids were skin tag(11.6%), anal<br>fistula(6.1%), anal fissure(5.4%), and anal polyp(5.1%) in the order of frequency. There<br>was no interval change.<br>11) The most common method of anesthesia for hemorrhoidectomy was the caudal<br>anewthesia(79.2%) but hemorrhoidectomy incidence under the local anesthesia was only<br>0.5%.<br>There was no interval change.<br>12) The common post-hemorrhoidectomy complications were urinary retention(7.7%),<br>edema(7.5%), and bleeding(2.6%) in the order of frequency with no interval change.<br>13) The duration of hospitalization was between 4 to 7 days(42%) and the mean time<br>was 8.78 days. The number of patients of the 2nd half was smaller than the number of<br>patients of the 1st half in 7 days of admission.<br>