How long does surgery for thrombotic external hemorrhoids take?

Written by Chen Tian Jing
Colorectal Surgery
Updated on September 13, 2024
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Thrombotic external hemorrhoid surgery primarily involves the excision of thrombotic external hemorrhoids. If it's simply an excision of external hemorrhoids, the surgery generally takes about half an hour. The recovery time post-surgery requires two to three weeks, mainly depending on the severity of the patient's condition and individual tissue healing rates, which can vary. After the excision surgery for thrombotic external hemorrhoids, a local wound is left, necessitating daily disinfection and dressing changes. When necessary, hemorrhoid ointment or muscle-generating Yuhong ointment may also be applied to promote healing and treatment.

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Written by Deng Heng
Colorectal Surgery
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Do external hemorrhoids always require surgery?

Simple external hemorrhoids do not necessarily require surgery. External hemorrhoids are mainly those that grow below the dentate line, and their main clinical manifestation is a foreign body sensation in the anus, which does not pose a significant risk to the body. Only thrombosed external hemorrhoids with obvious anal pain may not require surgery if the lump is small, as the thrombus can be absorbed on its own. Only those with large lumps need to have the thrombus removed to alleviate pain.

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Written by Yu Xu Chao
Colorectal Surgery
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The difference between internal and external hemorrhoids

Internal hemorrhoids are located above the dentate line in the anal canal, at the end of the rectum, and are innervated by the autonomic nervous system. Clinically, they are mainly characterized by intermittent, painless rectal bleeding. The blood is bright red, often dripping or spraying after defecation. If internal hemorrhoids worsen, they can prolapse and even become strangulated and edematous, causing anal swelling and pain. External hemorrhoids, on the other hand, are located below the dentate line in the anal canal, and are innervated by the spinal nerves, making them more sensitive to pain. Clinically, they are categorized into skin tag-type external hemorrhoids, varicose vein-type external hemorrhoids, inflammatory external hemorrhoids, and thrombotic external hemorrhoids. Skin tag-type and varicose vein-type external hemorrhoids primarily cause a sensation of a foreign body and itching in the anus, while inflammatory or thrombotic external hemorrhoids can lead to an increase in perianal secretions and anal swelling and pain, necessitating prompt surgical removal of the external hemorrhoids.

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Written by Chen Tian Jing
Colorectal Surgery
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Can thrombotic external hemorrhoids be lanced?

Thrombosed external hemorrhoids, as the most common clinical symptom of external hemorrhoids, exhibit significant local pain during acute attacks and are accompanied by a feeling of constriction. If during an acute attack, dark red hemorrhoidal prolapse occurs around the anal area and cannot be absorbed or retracted, a professional doctor can use specialized techniques to crush the local hemorrhoid node or surgically excise it. However, it is not advisable for patients to burst it themselves because if done without proper sterilization and hygiene, it can easily lead to local infection, thereby exacerbating the condition or complicating future surgical treatments. Therefore, if thrombosed external hemorrhoids are detected, it is crucial to seek prompt and active treatment at a hospital.

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Written by Yu Xu Chao
Colorectal Surgery
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Does the surgical removal of external hemorrhoids hurt?

Surgical removal of external hemorrhoids generally does not cause significant pain because anesthesia is required for the procedure. There are options for anesthesia, including local infiltration anesthesia, spinal anesthesia, or general anesthesia via intravenous injection, ensuring the patient does not experience notable pain during the surgery. However, post-surgery sensitivity is higher because the external hemorrhoids are innervated by perineal nerves. Therefore, it is crucial to use pain relief medication appropriately when changing dressings to alleviate discomfort. Additionally, it is essential to prevent infection, inflammation, or swelling of the wound to reduce postoperative pain. Patients should also manage their bowel movements to avoid dry, hard stools; smooth bowel movements can somewhat relieve postoperative pain. If the pain is particularly severe, the use of diclofenac sodium suppositories for anal insertion can help reduce inflammation and pain. (Please follow medical advice regarding medication use.)

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Written by Chen Tian Jing
Colorectal Surgery
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Can thrombotic external hemorrhoids be ruptured?

If a patient experiences an acute episode of thrombosed external hemorrhoids, the local pressure on the external hemorrhoids is generally high, and there are thromboses wrapped in the hemorrhoid nucleus. However, it is not advisable for patients to burst it on their own, as under unhygienic conditions, doing so could easily lead to local infection of the hemorrhoids, further exacerbating the condition. The treatment of thrombosed external hemorrhoids requires the professional management of a proctologist. Generally speaking, for mild symptoms, local use of Chinese herbal wash solutions or hemorrhoid creams can be chosen to press on the area, which helps promote the absorption of local thromboses. Alternatively, a professional proctologist can use specialized techniques to crush and press the local thromboses. If the thromboses are large or the local symptoms are severe, causing significant pain and severely affecting normal life, surgical excision might also be considered.