We performed a retrospective analysis of all patients undergoing
hemorrhoidectomy at a single institution over a 10-year period. Fisher's exact and Wilcoxon Rank Sum tests were utilized to test for association between delayed
bleeding and anticoagulation use.
RESULTS: Between January 2011 and October 2020, 1469
hemorrhoidectomies were performed. A total of 216 (14.7%) were taking
platelet inhibitors and 56 (3.8%) other
anticoagulants. Delayed
bleeding occurred in 5.2% (n = 76) of which 47% (n = 36) required operative intervention. Mean time to
bleeding was 8.7 days (SD ±5.9). Time to
bleeding was longer in those taking antiplatelet inhibitors vs. non-
platelet inhibitors vs. none (11 vs. 8 vs. 7 days, P = .05). Among
anticoagulants (n = 56), novel oral
anticoagulants were more common than
warfarin (57% vs 43%) and had a nonsignificant increase in delayed
bleeding (31% vs 16%, P = .21). Later restart (>3 days) of novel
anticoagulants after surgery was associated with increased
bleeding (10.5% vs 61.5%, P=.005). On multivariable analysis, only anticoagulation use (OR 4.5, 95% CI: 2.1-10.0), male sex (OR 1.8, 95% CI: 1.1-2.9), and operative oversewing (OR 3.5, 95% CI: 1.8-6.9) were associated with delayed
bleeding.
CONCLUSION: