XỬ TRÍ CHẢY MÁU THỨ PHÁT SAU MỔ TRĨ Ở BỆNH NHÂN PHẪU THUẬT LONGO

Abstract

Introduction: Recently, Longo surgery has become increasingly popular due to its advantages, such as less pain and faster recovery. However, hemorrhage after hemorrhoidectomy remains a significant concern. We developed and implemented the protocol " Management of Secondary Hemorrhage After Hemorrhoidectomy" at the Proctology Department, University Medical Center Ho Chi Minh City, Campus I (UMC HCMC CI), starting from January 1, 2017. Objective: To evaluate the effectiveness of the protocol in patients undergoing Longo surgery at the Proctology Department, UMC HCMC CI during the study period. Materials and Methods: A case series study was conducted on 46 patients who experienced secondary bleeding after Longo hemorrhoidectomy from January 1, 2022, to December 31, 2024, at the Proctology Department, UMC HCMC CI. Results: 2 patients required surgical hemostasis after failing to respond to Foley catheter tamponade. 19 patients were managed with Foley catheter placement combined with irrigation, 4 patients underwent enema due to fecal impaction, and the remaining 23 patients stabilized with conservative treatment. The incidence of secondary bleeding was 0.98%. Conclusion: The protocol demonstrated promising results and requires further long-term evaluation. The inpatient treatment duration was relatively short; however, further research is required to identify factors contributing to prolonged hospitalization. Fecal impaction is an important risk factor. The Foley catheter placement technique requires further investigation.