대한대장항문학회

<b>Purpose:</b> Secondary bleeding is an inevitable and a troublesome complication of hemorrhoidectomy. This study analyzed the factors related to secondary bleeding after hemorrhoidectomy.<br><br><b>Methods:</b> A total of 14,062 patients received a hemorrhoidectomy from Apr. 1999 to Apr. 2001. A retrospective study of 83 patients with secondary bleeding was done. At first, the doctors were divided into two groups. In one group, each doctor<br>had<br>performed more than 500 hemorrhoidectomies; in the other groups, each doctor had performed less than 500 hemorrhoidectomies. The incidence of secondary bleeding of the two groups was compared. Then, 155 patients without secondary bleeding were<br>randomly<br>selected as a control group. Clinical aspects and laboratory data were compared with those of the bleeding group.<br><br><b>Results:</b> The total incidence of secondary bleeding was 0.6%. The incidence for the group with experienced doctors was 0.5%, that for the other group was 1.3%. When bleeding patients were compared with the control group, the proportion of<br>patients<br>who received a blood transfusion within 1 week before operation was 12.1% in the bleeding group and 2.6% in the control group. The postoperative WBC count was increased more in the bleeding group. The percentage treated with metronidazole was 12%<br>compared with 25.3% in the control group. The incidences of bleeding according to operation sites were 19.6% in the right anterior, 12.2% in the left lateral, 10.9% in the right posterior, and 8.4% in the posterior portion.<br><br><b>Conclusions:</b> Secondary bleeding after a hemorrhoidectomy is more prevalent with less experienced doctors, recent history of blood transfusion, less use of metronidazole, and specific location of the hemorrhoid, such as the right anterior and<br>the<br>left lateral site of the hemorrhoid pile.<br>