肛門部尖圭コンジローマの外科切除後の再発の危険因子

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  • Factors Affecting Recurrence after Surgical Excision for Perianal Warts

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We review 122 patients of perianal warts who underwent surgical excisions between 2000 and 2004 inMatsushima hospital, to evaluate the outcome of surgical excision and the risk factors of postoperative recurrence.Clinical symptoms were feeling of lumps, itching, pain, bleeding and discharge. The perianal lesions were simple in 13 patients, sporadic in 48, multiple in 20, velvet-shaped in 13, comb-shaped in 17, and cauliflower-like in 6. Warts invaded the anal canal in 43%, and the vulva or the penis in 15%. Surgical excisions were performed under local anesthesia in 25 patients and under spinal anesthesia in 97.<BR>Postoperative complications such as prolonged wound healing, anal fissure and pruritis ani occurred in 16%. Local recurrence occurred within 6 months in 48% except one case. Multiple perianal lesions, presence of anal canal lesion and bleeding were significant risk factors of postoperative recurrence. It seemed that surgical resection for perianal warts is a good first choice, but recurrence occurs frequently, and postoperative follow-up for at least six months with adequate informed consent and guidance on sexual intercourse is required.

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