Subscribe to RSS
Please copy the URL and add it into your RSS Feed Reader.
https://www.thieme-connect.de/rss/thieme/en/10.1055-s-00000049.xml
Clin Colon Rectal Surg 2016; 29(01): 014-021
DOI: 10.1055/s-0035-1568145
DOI: 10.1055/s-0035-1568145
Review Article
Complications Following Anorectal Surgery
Further Information
Publication History
Publication Date:
16 February 2016 (online)
![](https://www.thieme-connect.de/media/ccrs/201601/lookinside/thumbnails/10-1055-s-0035-1568145_00709-1.jpg)
Abstract
Anorectal surgery is well tolerated. Rates of minor complications are relatively high, but major postoperative complications are uncommon. Prompt identification of postoperative complications is necessary to avoid significant patient morbidity. The most common acute complications include bleeding, infection, and urinary retention. Pelvic sepsis, while may result in dramatic morbidity and even mortality, is relatively rare. The most feared long-term complications include fecal incontinence, anal stenosis, and chronic pelvic pain.
-
References
- 1 Senagore AJ, Singer M, Abcarian H , et al; Procedure for Prolapse and Hemmorrhoids (PPH) Multicenter Study Group. A prospective, randomized, controlled multicenter trial comparing stapled hemorrhoidopexy and Ferguson hemorrhoidectomy: perioperative and one-year results. Dis Colon Rectum 2004; 47 (11) 1824-1836
- 2 MacRae HM, McLeod RS. Comparison of hemorrhoidal treatment modalities. A meta-analysis. Dis Colon Rectum 1995; 38 (7) 687-694
- 3 Nisar PJ, Acheson AG, Neal KR, Scholefield JH. Stapled hemorrhoidopexy compared with conventional hemorrhoidectomy: systematic review of randomized, controlled trials. Dis Colon Rectum 2004; 47 (11) 1837-1845
- 4 Hyman N, O'Brien S, Osler T. Outcomes after fistulotomy: results of a prospective, multicenter regional study. Dis Colon Rectum 2009; 52 (12) 2022-2027
- 5 Hall JF, Bordeianou L, Hyman N , et al. Outcomes after operations for anal fistula: results of a prospective, multicenter, regional study. Dis Colon Rectum 2014; 57 (11) 1304-1308
- 6 Cintron J, Abcarian H. Benign anorectal: hemorrhoids. In: Wolff BG, Fleshman JW, Beck DE, et al., eds. Hemorrhoids ASCRS Textbook of Colon and Rectal Surgery. New York, NY: Springer; 2007: 156-177
- 7 Rosen L, Sipe P, Stasik JJ, Riether RD, Trimpi HD. Outcome of delayed hemorrhage following surgical hemorrhoidectomy. Dis Colon Rectum 1993; 36 (8) 743-746
- 8 Place RJ, Coloma M, White PF, Huber PJ, Van Vlymen J, Simmang CL. Ketorolac improves recovery after outpatient anorectal surgery. Dis Colon Rectum 2000; 43 (6) 804-808
- 9 Chen HH, Wang JY, Changchien CR, Yeh CY, Tsai WS, Tang R. Effective management of posthemorrhoidectomy secondary hemorrhage using rectal irrigation. Dis Colon Rectum 2002; 45 (2) 234-238
- 10 Giordano P, Overton J, Madeddu F, Zaman S, Gravante G. Transanal hemorrhoidal dearterialization: a systematic review. Dis Colon Rectum 2009; 52 (9) 1665-1671
- 11 Sheikh F, Khubchandani IT, Rosen L, Sheets JA, Stasik JJ. Is anorectal surgery on chronic dialysis patients risky?. Dis Colon Rectum 1992; 35 (1) 56-58 k
- 12 Nelson RS, Ewing BM, Ternent C, Shashidharan M, Blatchford GJ, Thorson AG. Risk of late bleeding following hemorrhoidal banding in patients on antithrombotic prophylaxis. Am J Surg 2008; 196 (6) 994-999 , discussion 999
- 13 Bonardi RA, Rosin JD, Stonesifer Jr GL, Bauer FW. Bacteremias associated with routine hemorrhoidectomies. Dis Colon Rectum 1976; 19 (3) 233-236
- 14 Guy RJ, Seow-Choen F. Septic complications after treatment of haemorrhoids. Br J Surg 2003; 90 (2) 147-156
- 15 McCloud JM, Jameson JS, Scott AN. Life-threatening sepsis following treatment for haemorrhoids: a systematic review. Colorectal Dis 2006; 8 (9) 748-755
- 16 Bouchard D, Abramowitz L, Castinel A , et al; Groupe de Recherche En Proctologie de la Société Nationale Française de Colo-Proctologie (GREP); Club de Réflexion des cabinets et Groupe d'Hépato-Gastroentérologie (CREGG). One-year outcome of haemorrhoidectomy: a prospective multicentre French study. Colorectal Dis 2013; 15 (6) 719-726
- 17 Sielezneff I, Salle E, Lécuyer J, Brunet C, Sarles JC, Sastre B. Early postoperative morbidity after hemorrhoidectomy using the Milligan–Morgan technic. A retrospective studies of 1,134 cases. J Chir (Paris) 1997; 134 (5–6) 243-247
- 18 Grewal H, Guillem JG, Quan SH, Enker WE, Cohen AM. Anorectal disease in neutropenic leukemic patients. Operative vs. nonoperative management. Dis Colon Rectum 1994; 37 (11) 1095-1099
- 19 Morandi E, Merlini D, Salvaggio A, Foschi D, Trabucchi E. Prospective study of healing time after hemorrhoidectomy: influence of HIV infection, acquired immunodeficiency syndrome, and anal wound infection. Dis Colon Rectum 1999; 42 (9) 1140-1144
- 20 Khan KI, Akmal M, Waqas A, Mahmood S. Role of prophylactic antibiotics in Milligan–Morgan hemorrhoidectomy – a randomized control trial. Int J Surg 2014; 12 (8) 868-871
- 21 Cataldo PA, Senagore AJ. Does alpha sympathetic blockade prevent urinary retention following anorectal surgery?. Dis Colon Rectum 1991; 34 (12) 1113-1116
- 22 Petros JG, Bradley TM. Factors influencing postoperative urinary retention in patients undergoing surgery for benign anorectal disease. Am J Surg 1990; 159 (4) 374-376
- 23 Bowers FJ, Hartmann R, Khanduja KS, Hardy Jr TG, Aguilar PS, Stewart WR. Urecholine prophylaxis for urinary retention in anorectal surgery. Dis Colon Rectum 1987; 30 (1) 41-42
- 24 Zaheer S, Reilly WT, Pemberton JH, Ilstrup D. Urinary retention after operations for benign anorectal diseases. Dis Colon Rectum 1998; 41 (6) 696-704
- 25 Toyonaga T, Matsushima M, Sogawa N , et al. Postoperative urinary retention after surgery for benign anorectal disease: potential risk factors and strategy for prevention. Int J Colorectal Dis 2006; 21 (7) 676-682
- 26 Baldini G, Bagry H, Aprikian A, Carli F. Postoperative urinary retention: anesthetic and perioperative considerations. Anesthesiology 2009; 110 (5) 1139-1157
- 27 Sutherland LM, Burchard AK, Matsuda K , et al. A systematic review of stapled hemorrhoidectomy. Arch Surg 2002; 137 (12) 1395-1406 , discussion 1407
- 28 Shao WJ, Li GC, Zhang ZH, Yang BL, Sun GD, Chen YQ. Systematic review and meta-analysis of randomized controlled trials comparing stapled haemorrhoidopexy with conventional haemorrhoidectomy. Br J Surg 2008; 95 (2) 147-160
- 29 Tjandra JJ, Chan MK. Systematic review on the procedure for prolapse and hemorrhoids (stapled hemorrhoidopexy). Dis Colon Rectum 2007; 50 (6) 878-892
- 30 Milsom JW, Mazier WP. Classification and management of postsurgical anal stenosis. Surg Gynecol Obstet 1986; 163 (1) 60-64
- 31 Katdare MV, Ricciardi R. Anal stenosis. Surg Clin North Am 2010; 90 (1) 137-145
- 32 Liberman H, Thorson AG. How I do it. Anal stenosis. Am J Surg 2000; 179 (4) 325-329
- 33 Brisinda G, Vanella S, Cadeddu F , et al. Surgical treatment of anal stenosis. World J Gastroenterol 2009; 15 (16) 1921-1928
- 34 Rakhmanine M, Rosen L, Khubchandani I, Stasik J, Riether RD. Lateral mucosal advancement anoplasty for anal stricture. Br J Surg 2002; 89 (11) 1423-1424
- 35 Pearl RK, Hooks III VH, Abcarian H, Orsay CP, Nelson RL. Island flap anoplasty for the treatment of anal stricture and mucosal ectropion. Dis Colon Rectum 1990; 33 (7) 581-583
- 36 Christensen MA, Pitsch Jr RM, Cali RL, Blatchford GJ, Thorson AG. “House” advancement pedicle flap for anal stenosis. Dis Colon Rectum 1992; 35 (2) 201-203
- 37 Farid M, Youssef M, El Nakeeb A, Fikry A, El Awady S, Morshed M. Comparative study of the house advancement flap, rhomboid flap, and y-v anoplasty in treatment of anal stenosis: a prospective randomized study. Dis Colon Rectum 2010; 53 (5) 790-797
- 38 Sentovich SM, Falk PM, Christensen MA, Thorson AG, Blatchford GJ, Pitsch RM. Operative results of house advancement anoplasty. Br J Surg 1996; 83 (9) 1242-1244
- 39 Roig JV, Jordán J, García-Armengol J, Esclapez P, Solana A. Changes in anorectal morphologic and functional parameters after fistula-in-ano surgery. Dis Colon Rectum 2009; 52 (8) 1462-1469
- 40 Visscher AP, Schuur D, Roos R, Van der Mijnsbrugge GJ, Meijerink WJ, Felt-Bersma RJ. Long-term follow-up after surgery for simple and complex cryptoglandular fistulas: fecal incontinence and impact on quality of life. Dis Colon Rectum 2015; 58 (5) 533-539
- 41 Jordán J, Roig JV, García-Armengol J, García-Granero E, Solana A, Lledó S. Risk factors for recurrence and incontinence after anal fistula surgery. Colorectal Dis 2010; 12 (3) 254-260
- 42 Soltani A, Kaiser AM. Endorectal advancement flap for cryptoglandular or Crohn's fistula-in-ano. Dis Colon Rectum 2010; 53 (4) 486-495
- 43 Lindsey I, Jones OM, Smilgin-Humphreys MM, Cunningham C, Mortensen NJ. Patterns of fecal incontinence after anal surgery. Dis Colon Rectum 2004; 47 (10) 1643-1649
- 44 Johannsson HÖ, Påhlman L, Graf W. Functional and structural abnormalities after milligan hemorrhoidectomy: a comparison with healthy subjects. Dis Colon Rectum 2013; 56 (7) 903-908
- 45 Felt-Bersma RJ, van Baren R, Koorevaar M, Strijers RL, Cuesta MA. Unsuspected sphincter defects shown by anal endosonography after anorectal surgery. A prospective study. Dis Colon Rectum 1995; 38 (3) 249-253
- 46 Bharucha AE, Wald A, Enck P, Rao S. Functional anorectal disorders. Gastroenterology 2006; 130 (5) 1510-1518
- 47 Gravié JF, Lehur PA, Huten N , et al. Stapled hemorrhoidopexy versus Milligan–Morgan hemorrhoidectomy: a prospective, randomized, multicenter trial with 2-year postoperative follow up. Ann Surg 2005; 242 (1) 29-35
- 48 Ommer A, Hinrichs J, Möllenberg H, Marla B, Walz MK. Long-term results after stapled hemorrhoidopexy: a prospective study with a 6-year follow-up. Dis Colon Rectum 2011; 54 (5) 601-608
- 49 Oh C, Divino CM, Steinhagen RM. Anal fissure. 20-year experience. Dis Colon Rectum 1995; 38 (4) 378-382
- 50 García-Aguilar J, Belmonte Montes C, Perez JJ, Jensen L, Madoff RD, Wong WD. Incontinence after lateral internal sphincterotomy: anatomic and functional evaluation. Dis Colon Rectum 1998; 41 (4) 423-427
- 51 Murad-Regadas SM, Fernandes GO, Regadas FS , et al. How much of the internal sphincter may be divided during lateral sphincterotomy for chronic anal fissure in women? Morphologic and functional evaluation after sphincterotomy. Dis Colon Rectum 2013; 56 (5) 645-651
- 52 Altomare DF, Ratto C, Ganio E, Lolli P, Masin A, Villani RD. Long-term outcome of sacral nerve stimulation for fecal incontinence. Dis Colon Rectum 2009; 52 (1) 11-17
- 53 Wexner SD, Coller JA, Devroede G , et al. Sacral nerve stimulation for fecal incontinence: results of a 120-patient prospective multicenter study. Ann Surg 2010; 251 (3) 441-449
- 54 Glasgow SC, Lowry AC. Long-term outcomes of anal sphincter repair for fecal incontinence: a systematic review. Dis Colon Rectum 2012; 55 (4) 482-490
- 55 Ganio E, Altomare DF, Gabrielli F, Milito G, Canuti S. Prospective randomized multicentre trial comparing stapled with open haemorrhoidectomy. Br J Surg 2001; 88 (5) 669-674
- 56 Pescatori M, Gagliardi G. Postoperative complications after procedure for prolapsed hemorrhoids (PPH) and stapled transanal rectal resection (STARR) procedures. Tech Coloproctol 2008; 12 (1) 7-19
- 57 Ron Y, Avni Y, Lukovetski A , et al. Botulinum toxin type-A in therapy of patients with anismus. Dis Colon Rectum 2001; 44 (12) 1821-1826
- 58 Martellucci J, Naldini G, Del Popolo G, Carriero A. Sacral nerve modulation in the treatment of chronic pain after pelvic surgery. Colorectal Dis 2012; 14 (4) 502-507