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Hemorrhoidectomy Baltimore MD

Surgical removal of hemorrhoids (hemorrhoidectomy) is recommended for third- and fourth-degree internal hemorrhoids (with or without external hemorrhoids) when conservative treatment measures fail to alleviate severe burning, itching, swelling, protrusion, bleeding, and pain. It is also recommended for external hemorrhoids when medical treatment has failed and symptoms persist.

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Hemorrhoidectomy

Overview

Hemorrhoids are enlarged or dilated veins located in and around the rectum and anus. There are two types: external and internal. External hemorrhoids occur below the anal sphincter and protrude at the anus. Thrombosed hemorrhoids contain clotted blood and can cause pain. Thrombosis usually occurs in external hemorrhoids but does occur in both types. Thrombosed external hemorrhoids can be incised and the clot evacuated.

Internal hemorrhoids occur above the anal sphincter and are classified as first-degree, second-degree, third-degree, and fourth-degree. First- and second-degree hemorrhoids may bleed with defecation, and second-degree hemorrhoids protrude with defecation but return once

the patient stops straining. Third- and fourth-degree internal hemorrhoids may become enlarged and drop down (prolapse) through the anus. Third-degree hemorrhoids protrude with straining and can be pushed back through the anus manually. Fourth-degree cannot be managed manually and may be thrombosed.

Surgical Procedure

Hemorrhoidectomy may be performed under general anesthesia (the patient is rendered unconscious), under spinal anesthesia (the patient is numbed from the waist down), or under local anesthesia (the immediate area is injected with a numbing agent similar to that used at the dentist's office). The choice of anesthesia depends on the extent of surgery, the patient's health and personal preference, and surgical standards of the facility.

The patient lies on the operating table face down with the buttocks slightly elevated or on their back with their legs up in stirrups, so the anus and rectal area are exposed. After the anesthesia has taken effect, the area is cleaned with an antiseptic solution. The hemorrhoids are clamped, tied off, and cut away. The wound is then sutured. After the operation, the surgeon packs the anus with gauze or applies antibiotic ointment. A hemorrhoidectomy takes about 1 to 1 1/2 hours to perform.

Newer methods for hemorrhoid removal are being used. One method involves using an ultrasonic scalpel to cut away hemorrhoids. This method is quicker and does not require sutures. Another innovation is the stapled hemorrhoidectomy, in which tissue from further in the anus is used to close the wound with surgical staples after the hemorrhoids are removed. Patients may recover faster and have less postoperative pain, but some research has shown an increase in complications with this procedure.

Preoperative Care

Preoperative tests may include blood and urine tests, a chest x-ray, and an EKG, depending on the patient's health. These t...

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Resources

Stapled hemorrhoidectomy for acute hemorrhoidal crisis

from: MedicalVideos.us

Title: Stapled hemorrhoidectomy for acute hemo...

UNIVERSITY OF MARYLAND MEDICAL CENTER

from: Medicare.govHospitalCompare_General

ProviderNumber: 210002 Title: UNIVERSITY OF MARYL...

ProviderNumber: 210002

Title: UNIVERSITY OF MARYLAND MEDICAL CENTER

Address1: 22 S GREENE ST

City: BALTIMORE

State Code: MD

Zip Code: 21201

County: BALTIMORE CITY

Phone Number: 4103280313

Hospital Type: Acute Care Hospitals

Hospital Ownership: Voluntary non-profit - Private

Emergency Services: Yes

Registries: Registries: Cardiac Surgery - YES; Stroke Care - YES; Nursing Care - YES

Death from serious treatable complications after surgery Compared to National Average: Not Available - Number of Patients: NA; Rate: NA)

Collapsed lung due to medical treatment Compared to National Average: Not Available - Number of Patients: NA; Rate: NA)

Breathing failure after surgery Compared to National Average: Not Available - Number of Patients: NA; Rate: NA)

Serious blood clots after surgery Compared to National Average: Not Available - Number of Patients: NA; Rate: NA)

A wound that splits open after surgery Compared to National Average: Not Available - Number of Patients: NA; Rate: NA)

Accidental cuts and tears from medical treatment Compared to National Average: Not Available - Number of Patients: NA; Rate: NA)

Serious Complications Compared to National Average: Not Available (Number of Patients: NA; Rate: NA)

Death after surgery to repair a weakness in the abdominal aorta: Not Available (Number of Patients: NA; Rate: NA)

Deaths after admission for broken hip Compared to National Average: Not Available (Number of Patients: NA; Rate: NA)

Deaths from Certain Conditions Compared to National Average: Not Available (Number of Patients: NA; Rate: NA)

Patient Review Communication:
Nurses communicated well - Sometimes/Never: 6; Usually: 19; Always: 75
Doctors communicated well - Sometimes/Never: 4; Usually: 17; Always: 79
Receive help as soon as they want - Sometimes/Never: 13; Usually: 27; Always: 60
Pain was well controlled - Sometimes/Never: 7; Usually: 25; Always: 68
Explained about medicines before giving it to them - Sometimes/Never: 17; Usually: 19; Always: 64
Clean room and bathroom - Sometimes/Never: 15; Usually: 23; Always: 62
Area around their room were quiet at night - Sometimes/Never: 16; Usually: 31; Always: 53
Provided recovery at home instructions - Yes: 87; No: 13
Hospital rating (O to 10; 10 highest) - 6 or lower: 8; 7 or 8: 24; 9 or 10: 68
YES, would recommend the hospital: 73
Number of completed Surveys: 300 or more

Patients who gave their hospital a rating of 9 or 10 on a scale: 68

Percentage of Patients who would recommend the hospital: Definitely Recommend: 73; Probably Recommend: 23; Not Recommend: 4

Surgery patients given the right antibiotic to prevent infection: NA

Patients treated at the right time within 24 hrs before or after: NA

Outpatients having surgery who got an antibiotic at the right time: NA

Outpatients having surgery who got the right kind of antibiotic: NA

SAINT JOSEPH MEDICAL CENTER

from: Medicare.govHospitalCompare_General

ProviderNumber: 210007 Title: SAINT JOSEPH MEDICA...

ProviderNumber: 210007

Title: SAINT JOSEPH MEDICAL CENTER

Address1: 7601 OSLER DRIVE

City: TOWSON

State Code: MD

Zip Code: 21204

County: BALTIMORE

Phone Number: 4103371200

Hospital Type: Acute Care Hospitals

Hospital Ownership: Voluntary non-profit - Church