title: Prospective randomized study of bacteraemia in diathermy and stapled haemorrhoidectomy.
abstract: BACKGROUND
  The incidence and consequences of bacteraemia associated with diathermy and stapled haemorrhoidectomy have not been studied previously.
  
  
  METHODS
  Two hundred and five healthy patients randomized to stapled haemorrhoidectomy or diathermy haemorrhoidectomy had perioperative blood cultures taken. The clinical sequelae of bacteraemia and complications of surgery were assessed prospectively.
  
  
  RESULTS
  Six patients were excluded for protocol violations. Eleven (11 per cent) of 101 patients with stapled and five (5 per cent) of 98 who had diathermy haemorrhoidectomy had positive blood cultures for organisms after haemorrhoidectomy, predominantly anaerobes commonly found within the bacterial flora of the anorectum (P = 0.19). Transient postoperative pyrexia in several patients did not correlate with detected bacteraemia and settled spontaneously without treatment. There were no serious complications from either operative technique, and no clinical consequences from proven bacteraemia.
  
  
  CONCLUSIONS
  Transient bacteraemia may complicate surgical haemorrhoidectomy but has no serious clinical consequences for healthy adults.
authors.affiliation: Department of Colorectal Surgery, Singapore General Hospital, Outram Road, Singapore 169608.
authors.forename: A
authors.initials: A
authors.lastname: Maw
authors.forename: R
authors.initials: R
authors.lastname: Concepcion
authors.forename: K W
authors.initials: KW
authors.lastname: Eu
authors.forename: F
authors.initials: F
authors.lastname: Seow-Choen
authors.forename: S M
authors.initials: SM
authors.lastname: Heah
authors.forename: C L
authors.initials: CL
authors.lastname: Tang
authors.forename: A L
authors.initials: AL
authors.lastname: Tan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000209:etiology / Q000382:microbiology / Q000517:prevention & control*; D004564:Electrocoagulation / Q000379:methods*; D005260:Female; D006484:Hemorrhoids / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000382:microbiology / Q000517:prevention & control*; D011446:Prospective Studies; D017792:Surgical Stapling; D013536:Suture Techniques