Occurrence and risk factors of anal margin edema after Milligan-Morgan hemorrhoidectomy in patients with mixed hemorrhoids / 中国基层医药

ABSTRACT

Objective:To investigate the risk factors of anal margin edema after Milligan-Morgan hemorrhoidectomy (MMH) in patients with mixed hemorrhoids.Methods:The clinical data of 600 patients with mixed hemorrhoids undergoing MMH in the First People's Hospital of Wenling from January 2017 to January 2020 were retrospectively analyzed. The patients were divided into study (with anal margin edema, n = 272) and control (without anal margin edema, n = 328) groups according to whether anal margin edema occurred after surgery. Gender, age, surgical incision suture, internal anal sphincter relaxation, infection, intraoperative operation, postoperative defecation, and postoperative fumigation with traditional Chinese medicine were compared. The risk factors of anal margin edema after MMH were analyzed by univariate analysis and logistic regression analysis. Results:There were no significant differences in suture of surgical incision [20.22%(55/272) vs. 18.29% (60/328)], infection [15.44% (42/272) vs. 17.68% (39/328)], internal anal sphincter relaxation [15.81% (43/272) vs. 17.68% (58/328)], and postoperative fumigation with traditional Chinese medicine [72.79% (198/272) vs. 71.65% (235/328)] between the two groups ( χ2 = 0.35, 1.60, 0.37, 0.09, all P > 0.05). Multivariate logistic regression analysis showed that female gender, age ≤ 60 years, unreasonable postoperative operation, and abnormal defecation were all independent risk factors for anal margin edema after MMH ( OR = 2.28, 2.52, 5.95, 3.07, all P < 0.05). Conclusion:Gender, age, surgical operation, and postoperative defecation are the risk factors for anal margin edema after MMH. Clinically, it is necessary to carry out reasonable perioperative intervention to avoid the occurrence of postoperative anal margin edema.