Is Surgery for External Hemorrhoids Safe After Stomach Cancer?

Q: Is Surgery for External Hemorrhoids Safe After Stomach Cancer?

Hello： Regarding your questions： 1. <br>Hemorrhoid surgery is generally performed under local anesthesia, and the procedure is not lengthy. <br>Typically, unless the patient is bedridden and unable to move, there are no concerns about physical stamina; rather, the necessity of un

External hemorrhoid surgery

Hello Dr.
Ke, my father, who is 58 years old, underwent a total gastrectomy for gastric adenocarcinoma on July 3 and has since returned home to rest.
His physical strength is currently somewhat diminished, and he is experiencing low blood pressure.
Prior to the surgery, he had ongoing issues with external hemorrhoids, which became painful at the end of August.
After a consultation, the doctor recommended surgical removal, but the family decided against it due to concerns about his ability to tolerate the procedure.
I would like to ask: *Is it appropriate for my father to undergo surgery given his current condition?* *If he undergoes surgery for the external hemorrhoids, could it lead to abdominal distension or trigger regurgitation?* *If he does not have the surgery, what potential consequences could arise? Is topical medication a viable option? Thank you.*

Evelyn, 20~29 year old female. Ask Date: 2002/09/02

Dr. Ke Fangxu reply Surgery

Hello: Regarding your questions: 1.
Hemorrhoid surgery is generally performed under local anesthesia, and the procedure is not lengthy.
Typically, unless the patient is bedridden and unable to move, there are no concerns about physical stamina; rather, the necessity of undergoing surgery should be considered.
2.
Common postoperative issues after hemorrhoid surgery usually include pain and bleeding, while bloating or regurgitation is less common.
3.
The decision to surgically remove external hemorrhoids depends on whether the hemorrhoids are swollen, painful, or bleeding severely enough that medication cannot improve the condition, or if the patient feels significantly troubled by the long-term discomfort.
Otherwise, surgery is not typically recommended unless there is a large area of acute thrombosed hemorrhoids.
In general, surgery would not be suggested hastily before attempting medical treatment.
If the anal area is not severely swollen all around, then not undergoing surgery should not lead to any adverse long-term effects.

Reply Date: 2002/09/02

More Info

When considering surgery for external hemorrhoids after a significant procedure like total gastrectomy for stomach cancer, several factors must be taken into account, particularly the patient's overall health, recovery status, and the potential risks associated with additional surgery.

1. Suitability for Surgery: Given that your father is 58 years old and has recently undergone a major surgery, his current physical condition is crucial in determining whether he is fit for another operation. After a total gastrectomy, patients often experience fatigue, nutritional deficiencies, and other complications that can affect their ability to tolerate further surgical procedures. It is essential to have a thorough evaluation by his healthcare team, including his surgeon and possibly a cardiologist, to assess his overall health and ability to withstand anesthesia and the stress of surgery.

2. Risks of Surgery: If surgery for external hemorrhoids is deemed appropriate, it is important to discuss the potential risks. While hemorrhoid surgery is generally considered safe, in a patient who has recently undergone major surgery, there may be concerns about complications such as infection, delayed healing, or exacerbation of existing conditions. Additionally, the recovery from hemorrhoid surgery could be more complicated due to the recent gastrectomy.

3. Impact of Surgery on Gastrointestinal Function: Regarding your concerns about whether hemorrhoid surgery could lead to gas or regurgitation (倒食), these symptoms are generally not directly associated with hemorrhoid surgery. However, any surgical procedure can potentially affect bowel function temporarily. It is crucial to monitor your father's recovery closely and communicate any new or worsening symptoms to his healthcare provider.

4. Consequences of Not Having Surgery: If your father opts not to have the hemorrhoid surgery, he may continue to experience discomfort, pain, or bleeding associated with the external hemorrhoids. In some cases, untreated hemorrhoids can lead to complications such as thrombosis (blood clots) or infection. Conservative management, including topical treatments and dietary modifications to prevent constipation, may provide some relief, but it is essential to discuss these options with his doctor.

5. Topical Treatments: Using topical medications can be an effective way to manage symptoms of external hemorrhoids. Over-the-counter creams or ointments that contain hydrocortisone or witch hazel can help reduce inflammation and discomfort. However, these treatments do not eliminate the hemorrhoids and may only provide temporary relief.

6. Overall Recommendations: It is advisable to have a detailed discussion with your father's healthcare team about the risks and benefits of proceeding with hemorrhoid surgery versus conservative management. If surgery is not an option due to his current health status, focusing on symptom management and lifestyle modifications, such as increasing fiber intake and hydration, may be beneficial.

In conclusion, the decision to proceed with surgery for external hemorrhoids after stomach cancer surgery should be made collaboratively with your father's healthcare providers, considering his overall health, recovery status, and the potential risks involved. Regular follow-ups and open communication with his medical team will be key in managing his health effectively during this recovery period.

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