Skip to main content
2024 ASCRS Annual Scientific Meeting Main banner
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Presentation Icons
CME
CME
Invitation/Ticketed Event
Invitation/Ticketed Event
Invited Lectureship
Invited Lectureship
Award Recipient
Award Recipient
Live Streamed Session
Live Streamed Session
Nurses Contact Hours
Nurses Contact Hours
Self-Assessment
Self-Assessment
Back

Session: ePoster Monitor 4-Benign Anorectal Disease 3

eP751 - Decisional Regret in Excisional Hemorrhoidectomy-A Pilot Study

Tuesday, June 4, 2024
8:18 AM – 8:23 AM ET, USA
Location: Baltimore Convention Center, Room 318-320

    Senior Author(s)

  • JG

    John A. Griffin, MD

    Director of Research for CRS
    Swedish Colon and Rectal Clinic
    Seattle, Washington, United States

    Disclosure information not submitted.

    • Author(s)

  • MH

    Melinda E. Hawkins, MD

    Colon and Rectal Surgeon
    Swedish Medical Center
    Seattle, WA, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • JS

    James M. Scanlan, PhD

    Scientific Writer
    Swedish Center for Research and Innovation
    Shoreline, Washington, United States

    Disclosure information not submitted.

  • UW

    Ulrik G. Wallin, PhD, MS

    Colon and Rectal Surgeon
    Polyclinic
    Seattle, Washington, United States

    Disclosure information not submitted.

  • Alexandra Wilson, DO

    CRS Fellow
    Swedish Medical Center
    Swedish Hospital
    Seattle, WA, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

  • Kenley Unruh, MD

    CRS Fellow
    Swedish Medical Group
    Swedish Cancer Institute
    Seattle, WA, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • ePoster Presenter(s)

  • Ruben M. Lesnick, MD (he/him/his)

    General Surgery Resident
    Swedish Medical Center
    Seattle, WA, United States

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • RE

    Ryan Emanuelson, MD

    General Surgery Resident
    Swedish Medical Center
    Seattle, Washington, United States

    Disclosure information not submitted.

  • AP

    Anna Paliaro, ARNP

    CRS Nurse Practitioner
    Swedish Cancer Institute
    Seattle, Washington, United States

    Disclosure information not submitted.

Purpose/Background: Background: Excisional hemorrhoidectomy is the most painful surgery that we as colon and rectal surgeons perform on patients. Often the recovery is difficult and both patients and surgeons may express regret for proceeding with such a procedure. But the amount of regret has never been quantified. We use a validated Decisional Regret Scale in a telephone survey to assess the regret patients have after an excisional hemorrhoidectomy to better set expectations for patients in the future. Our hypothesis is that there will be an elevated level of regret in excisional hemorrhoidectomy patients.Methods/Interventions:

Methods: We used a validated Decisional Regret Scale composed of 5 questions in a retrospective telephone survey of excisional hemorrhoidectomy patients to assess their level of regret. We combined it with a Hemorrhoidal Disease Symptom Score and Short Health Scale to get an idea of the severity of their symptoms. Descriptive statistics, correlations and Chi-Squares were used to examine potential relationships between regret measures, demographics, symptoms and surgical outcomes. SPSS 22 was used for statistical analyses.Results/Outcomes:

Results: One hundred and twenty-one patients were telephoned, 50 patients answered (41%) and 40 completed the survey for a response rate of 33%. The 5 questions were dichotomized so there were 2 groups: 1 group with no regret and 1 group with varying degrees of regret. Symptom severity was compared in both groups. On analysis there is a striking lack of regret in most patients. Overall, 76% strongly believe they made the right decision, 81% have no regrets and 78% would make the same choice if in the same situation again. Over the entire dataset, significant predictors of regret were not evident. However, sex differences were found. Male responders 100% strongly agreed that this was the right decision. They lacked regret and they would make the same choice again. In contrast, 50% of women strongly agreed that this was the right decision, 61% indicated they lacked regret, and 56% would make the same choice again (all of these sex differences p < .01). Women also self-reported greater pain from the surgery (p < .002). 28% of women reported pain everyday vs 6% of men. 44% of men reported no pain vs. 0% of women. Finally, women reported a greater but not statistically significant frequency of postoperative complications (61% vs 31% p=.082).Conclusion/

Discussion:

Conclusion: Surprisingly most excisional hemorrhoidectomy patients do not have a lot of regret after surgery. Expectations for pain early after surgery should be set but only in light of patients not regretting the long-term results of hemorrhoidectomy. Sex differences in pain and postoperative complications should be examined in future studies. Further study of regret in single quadrant hemorrhoidectomy as well as office-based procedures should also be performed to further evaluate decisional regret across additional methods of treatment.