Antibiotics and Early Post Operative Complications of Closed Hemorrhoidectomy: A Retrospective Matched Pair Study
Warin Wesarachawit MD*, Jirawat Pattana-arun MD*
Affiliation : * Division of Colorectal Surgery, Department of Surgery, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand
Objective : The purpose of the present study was to compare early post-operative complications and length of
hospital stay of hemorrhoidectomy patients between those who had and had not received metronidazole peri-
operatively.
Research
Design : Retrospective, matched pair case-control study.
Materials and Methods : Medical records of all hemorrhoidal patients hospitalized between January 2000 and
December 2005 were reviewed. Hemorrhoidectomy patients who had and had not received metronidazole
perioperatively during this period were matched based on demographic data. Demographic data including
bodyweight and number of hemorrhoidectomies of both groups were collected. Length of hospital stay and
immediate post-operative complications (bleeding, urinary retention, and wound dehiscence at 2nd and 4th
week), the total dosages of pethidine, acetaminophen, and NSAIDs were analyzed and compared by the
McNemar and the Wilcoxon Signed Rank Test.
Results : Of 1,184 patients who completed the follow-up protocol, 88 patients (male: female = 31:57) who had
received metronidazole could be matched by gender, age, NSAIDs used, number of hemorrhoids resected and
operation in the same period with 88 patients (male:female = 31:57) who had not. There were six (6.8%) and
seven (8%) patients with urinary retention in the metronidazole group and non-antibiotic group respectively.
One patient in each group (1.1%) experienced bleeding that ceased spontaneously. The length of hospital
stay was 1.14 + 0.35 (ranged 1-2) and 1.11 + 0.35 (ranged 1-3) days in the metronidazole and the non-
antibiotic group respectively, showing no significant difference (p = 0.683). There was no significant difference
in the total dosages of pethidine given postoperatively, which was 1.06 + 0.83 and 1.03 + 0.78 mg/kg in the
metronidazole and the non-antibiotic group respectively (p = 0.747). At the 2nd week, there were two wound
dehiscences (2.25%) in each group. At the 4th week, no more new wound dehiscence was detected and all were
completely healed without stricture.
Conclusion : There was no benefit of metronidazole on closed hemorrhoidectomy with respect to post-opera-
tive complications, length of hospital stay, and total analgesics used.
Keywords : Hemorrhoid, Hemorrhoidectomy, Wound dehiscence, Metronidazole
