Perirectal Hematoma and Intra-Abdominal Bleeding after Stapled Hemorrhoidopexy and STARR—A Proposal for a Decision-Making Algorithm
Abstract
:1. Introduction
2. Materials and Methods
- (“hemorrhage” [MeSH Terms] OR “hemorrhage” [All Fields] OR “bleeding” [All Fields]) AND stapled [All Fields] AND haemorrhoidopexy [All Fields];
- (“hemorrhage” [MeSH Terms] OR “hemorrhage” [All Fields] OR “bleeding” [All Fields]) AND stapled [All Fields] AND mucosectomy [All Fields];
- (“postoperative hemorrhage” [MeSH Terms] OR (“postoperative” [All Fields] AND “hemorrhage” [All Fields]) OR “postoperative hemorrhage” [All Fields] OR (“post” [All Fields] AND “operative” [All Fields] AND “hemorrhage” [All Fields]) OR “postoperative hemorrhage” [All Fields]) AND (“hemorrhoidectomy” [MeSH Terms] OR “hemorrhoidectomy” [All Fields])
- hemorrhage OR bleeding AND stapled OR haemorrhoidopexy
- hemorrhage stapled mucosectomy
- Postoperative hemorrhage hemorrhoidectomy
3. Results
4. Discussion
- progressive hematoma: the patient is hemodynamically unstable (i.e., in hemorrhagic shock), and it is necessary to carry out an emergency intervention to stop the bleeding [29]. This approach is part of the philosophy of Damage Control Surgery (DCS) with a subsequent definitive intervention after the stabilization of the hemodynamic status [37].
- stable pararectal hematoma: the patient is hemodynamically stable, so it is possible to perform a nonoperative treatment.
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Author and Year of Publication | Reasons of Exclusion |
---|---|
Gallo 2020 | A consensus statement on management and treatment of hemorrhoidal disease |
Wang 2020 | A comparative study between DST and PPH staplers in the treatment of grade III and IV hemorrhoids. None case of perirectal hematoma was reported |
Lin 2019 | A randomized clinical trial about partial stapled hemorrhoidopexy versus circumferential stapled hemorrhoidopexy for grade III to IV prolapsing hemorrhoids |
Jeong 2017 | A cohort study about partial Stapled Hemorrhoidopexy |
Andreucetti 2014 | A postoperative intra-abdominal bleeding after pile suturing |
Lin 2012 | A comparative study between partial stapled hemorrhoidopexy versus circular stapled hemorrhoidopexy for grade III–IV prolapsing hemorrhoids. None case of perirectal hematoma was reported |
Arezzo 2011 | A review of literature |
Ref | Author and Year of Publication | Nation | Type of Study | Number of Patients Reported | Indication to Surgery | Type of Stapler (Number of Patients) |
---|---|---|---|---|---|---|
[30] | Ripamonti 2019 | Italy | Case report | 1 | third-degree hemorrhoids | 1 SH (PPH-03) |
[27] | Rajkumar 2018 | India | Case report | 1 | third-degree hemorrhoids | Other version of the gun |
[26] | Ferrara 2018 | Italy | Case report | 1 | third-degree hemorrhoids | 1 SH (PPH-03) |
[19] | Tebala 2016 | Isle of Man | Case report | 1 | ODS | 1 STARR |
[25] | Cerullo 2015 | Italy | Case report | 1 | ODS | 1 STARR |
[32] | Safadi 2014 | Israel | Case report | 1 | third-degree hemorrhoids | 1 SH |
[24] | Shahzad 2013 | Pakistan | Case report | 1 | third-degree hemorrhoids | 1 SH |
[33] | De Santis 2012 | Italy | Case report | 1 | third-degree hemorrhoids | 1 SH (PPH-03) |
[23] | Naldini 2011 | Italy | Multicentric cohort study | 15 | NR | 4 SH (PPH-01) 9 SH (PPH-03) 2 STARR |
[29] | Joyce 2012 | Ireland | Case report | 1 | third-degree hemorrhoids | 1 SH (PPH-03) |
[22] | Chikkappa 2010 | UK | Case report | 1 | second-degree hemorrhoids | 1 STARR |
[28] | Augustin 2009 | Croatia | Case report | 1 | third-degree hemorrhoids | 1 SH (PPH-03) |
[31] | Blouhos 2007 | Greece | Case report | 1 | third-degree hemorrhoids | 1 SH (PPH-03) |
[21] | Grau 2005 | Spain | Case report | 1 | third-degree hemorrhoids | 1 SH (PPH-01) |
[3] | Oughriss 2005 | France | Multicentric cohort study | 8 | third-degree hemorrhoids | NR |
[20] | Meyer 2004 | Germany | Case report | 1 | third-degree hemorrhoids | 1 SH (PPH-01) |
[34] | Aumann | Germany | Case report | 1 | third-degree hemorrhoids | 1 SH (PPH-01) |
P | Author and Year of Publication | Timing of Bleeding (POD) | Hemoglobin Levels (mg/dL) | Sign and Symptoms | Hemodynamic Instability | CT Evaluation |
---|---|---|---|---|---|---|
[30] | Ripamonti 2019 | 1 | 7.6 | Back and abdominal pain | No | Yes |
[27] | Rajkumar 2018 | 3 | NR | Bleeding per rectum | No | Yes |
[26] | Ferrara 2018 | <1 | 10 | Abdominal and pelvic pain discomfort | No | Yes |
[19] | Tebala 2016 | 2 | 8.8 | Pelvic discomfort | No | Yes |
[25] | Cerullo 2015 | 1 | 7.5 | Asymptomatic | No | Yes |
[32] | Safadi 2014 | 2 | 8.9 | Abdominal pain | No | Yes |
[24] | Shahzad 2013 | 4 | NR | Bleed ing per rectum | No | Yes |
[33] | De Santis 2012 | 6 | NR | Bleed ing per rectum | No | Yes |
[23] | Naldini 2011 | NR | NR | NR | No 10 Yes 5 | NR |
[29] | Joyce 2012 | <1 | 8.8 | Shock | Yes | No |
[22] | Chikkappa 2010 | 1 | 9.3 | Urinary retention | No | No |
[28] | Augustin 2009 | 1 | NR | Abdominal and pelvic pain | No | Yes |
[31] | Blouhos 2007 | 1 | 6.2 | Abdominal and pelvic pain | Yes | Yes |
[21] | Grau 2005 | <1 | 7.8 | Urinary retention—pelvic pain | Yes | Yes |
[3] | Oughriss 2005 | NR | NR | NR | No | NR |
[20] | Meyer 2004 | 1 | 8.9 | Abdominal pain | No | Yes |
[34] | Aumann 2004 | 1 | NR | Abdominal pain | No | Yes |
Ref | Author and Year of Publication | Type of Treatment (Number of Patients) | Surgical Treatment/Interventional Radiological Treatment (Number of Patients) |
---|---|---|---|
[30] | Ripamonti 2019 | NOM | - |
[27] | Rajkumar 2018 | NOM | Angioembolization |
[26] | Ferrara 2018 | NOM | Angioembolization |
[19] | Tebala 2016 | NOM | Diagnostic laparoscopy |
[25] | Cerullo 2015 | NOM | Diagnostic laparoscopy |
[32] | Safadi 2014 | NOM | - |
[24] | Shahzad 2013 | NOM | Angioembolization |
[33] | De Santis 2012 | Explorative laparotomy | Colostomy |
[23] [29] [22] [28] [31] [21] [3] [20] | Naldini 2011 | Explorative laparotomy (4) | Colostomy (2) |
Bilateral ligation of the internal iliac arteries | |||
Ligation of vessel on the rectal wall | |||
NOM (5) | Diagnostic laparoscopy | ||
Angioembolization | |||
Drain the haematoma (6) | Rectotomy (4) | ||
Perineal incisions | |||
CT-guided paracoccygeal | |||
[34] | Joyce 2012 | Explorative laparotomy | Colostomy |
[30] | Chikkappa 2010 | Drain the haematoma | Rectotomy |
[27] | Augustin 2009 | Explorative laparotomy | Hartmann’s resection |
[26] | Blouhos 2007 | Explorative laparotomy | Low Anterior Resection of the Rectum |
[19] | Grau 2005 | NOM | - |
[25] | Oughriss 2005 | Drain the haematoma (8) | Rectotomy (8) |
[32] | Meyer 2004 | NOM | - |
[24] | Aumann 2004 | Explorative laparotomy | Suture of the rectum |
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Popivanov, G.; Fedeli, P.; Cirocchi, R.; Lancia, M.; Mascagni, D.; Giustozzi, M.; Teodosiev, I.; Kjossev, K.; Konaktchieva, M. Perirectal Hematoma and Intra-Abdominal Bleeding after Stapled Hemorrhoidopexy and STARR—A Proposal for a Decision-Making Algorithm. Medicina 2020, 56, 269. https://doi.org/10.3390/medicina56060269
Popivanov G, Fedeli P, Cirocchi R, Lancia M, Mascagni D, Giustozzi M, Teodosiev I, Kjossev K, Konaktchieva M. Perirectal Hematoma and Intra-Abdominal Bleeding after Stapled Hemorrhoidopexy and STARR—A Proposal for a Decision-Making Algorithm. Medicina. 2020; 56(6):269. https://doi.org/10.3390/medicina56060269
Chicago/Turabian StylePopivanov, Georgi, Piergiorgio Fedeli, Roberto Cirocchi, Massimo Lancia, Domenico Mascagni, Michela Giustozzi, Ivan Teodosiev, Kirien Kjossev, and Marina Konaktchieva. 2020. "Perirectal Hematoma and Intra-Abdominal Bleeding after Stapled Hemorrhoidopexy and STARR—A Proposal for a Decision-Making Algorithm" Medicina 56, no. 6: 269. https://doi.org/10.3390/medicina56060269