{
  "abstract": "Background\n\nSurgical management of hemorrhoidal disease (HD) in patients with IBD remains controversial because of concerns about impaired outcomes. This study aimed to evaluate the safety and IBD-related outcomes of surgical treatments for HD in patients with IBD and to explore factors potentially associated with postoperative complications and IBD flare.Methods\n\nHEAD-IBD is a retrospective cohort study promoted by the Italian Group for the study of IBD (IG-IBD). Adults with established ulcerative colitis (UC) or Crohn's disease (CD) who underwent surgery for HD between 2004 and 2024 and had at least 12 months of follow-up were included. Surgical techniques, 1-, 6-, and 12-month complications, IBD flares (6 months), new onset perianal disease, and continence outcomes were analyzed.Results\n\nA total of 38 patients were included (21 UC, 17 CD), 55% male. Clinically active disease at the last gastroenterology visit prior to surgery was present in 24% of UC and 41% of patients with CD. Open excisional hemorrhoidectomy was the most frequently performed procedure in both groups (66% UC, 73% CD), while non-excisional techniques were used in approximately one-third of cases. No 30-day or 6-month surgical complications occurred in patients with CD. Postoperative surgical complications were observed exclusively in patients with UC (5/21, 24%) and were mostly mild. Within 6 months after surgery, IBD flares occurred in 6 patients (16%), proportionally comparable between CD and UC. During overall follow-up, new-onset perianal disease developed in 5 patients (13%), predominantly in CD (4/5 cases), while new-onset incontinence was observed in 2 (5%) patients, both managed conservatively.Conclusions\n\nIn this largest European multicenter cohort, surgical treatment of HD in IBD was associated with low morbidity and preservation of anorectal function. These findings support a more individualized approach and underscore the need for prospective studies.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Medicine (DIMED), University of Padova, Padua, Italy. carla.felice@unipd.it.",
    "Medicine 1, Ca' Foncello University Hospital, Treviso, Italy. carla.felice@unipd.it.",
    "Department of Translational Medicine and Surgery, Hospital Isola Tiberina Gemelli Isola, Catholic University of Rome, Rome, Italy.",
    "Colorectal Surgery Unit, Faculty of Medicine and Surgery, IRCCS San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy.",
    "University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland.",
    "Gastroenterology Unit, Ca' Foncello University Hospital, Treviso, Italy.",
    "Department of Surgical Sciences, University of Rome Tor Vergata, Rome, Italy.",
    "Medicine 1, Ca' Foncello University Hospital, Treviso, Italy.",
    "Medicina Interna e Gastroenterologia, UOS Malattie Infiammatorie Croniche Intestinali, IBD Unit, CEMAD - Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy.",
    "Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy.",
    "L. Sacco University Hospital General Surgery II, Milan, Italy.",
    "Department of Gastroenterology, IBD Unit, San Filippo Neri Hospital, ASL ROMA 1, Rome, Italy.",
    "UOC Chirurgia Generale, AUSL Modena, Modena, Italy.",
    "Department of Surgery, Oncology and Gastroenterology, University of Padova, Padua, Italy.",
    "Proctology and Pelviperineology Unit, Humanitas Gavazzeni and Castelli, Bergamo, Italy."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 18,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "C Felice",
      "orcid": "0000-0001-6646-6231"
    },
    {
      "affs": [
        2
      ],
      "name": "D Pugliese",
      "orcid": "0000-0001-7930-5402"
    },
    {
      "affs": [
        3
      ],
      "name": "G Gallo",
      "orcid": "0000-0003-1066-4671"
    },
    {
      "affs": [
        4
      ],
      "name": "G L Di Tanna",
      "orcid": "0000-0002-5470-3567"
    },
    {
      "affs": [
        5
      ],
      "name": "M Ascolani",
      "orcid": "0000-0002-8286-3883"
    },
    {
      "affs": [
        6
      ],
      "name": "G S Sica",
      "orcid": "0000-0002-7407-0584"
    },
    {
      "affs": [
        6
      ],
      "name": "V Bellato",
      "orcid": "0000-0003-0123-1700"
    },
    {
      "affs": [
        7
      ],
      "name": "M Franco",
      "orcid": "0009-0009-0503-8378"
    },
    {
      "affs": [
        8,
        9
      ],
      "name": "F Scaldaferri",
      "orcid": "0000-0001-8334-7541"
    },
    {
      "affs": [
        8,
        9
      ],
      "name": "L Parisio",
      "orcid": "0000-0001-8481-4164"
    },
    {
      "affs": [
        10
      ],
      "name": "F Colombo",
      "orcid": "0000-0002-6478-7055"
    },
    {
      "affs": [
        10
      ],
      "name": "A Bondurri",
      "orcid": "0000-0002-6521-5876"
    },
    {
      "affs": [
        10
      ],
      "name": "C Guerci",
      "orcid": "0000-0002-6493-1299"
    },
    {
      "affs": [
        11
      ],
      "name": "A Aratari",
      "orcid": "0000-0001-8816-6950"
    },
    {
      "affs": [
        11
      ],
      "name": "S Festa",
      "orcid": "0000-0002-4635-3050"
    },
    {
      "affs": [
        12
      ],
      "name": "F Ascari",
      "orcid": "0000-0002-9959-0922"
    },
    {
      "affs": [
        13
      ],
      "name": "E V Savarino",
      "orcid": "0000-0002-3187-2894"
    },
    {
      "affs": [
        14
      ],
      "name": "U Grossi",
      "orcid": "0000-0001-5372-2873"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/58dyqqt3k5rnw.bib",
  "cited_by": 0,
  "doi": "10.1007/s10151-026-03394-6",
  "fulltext_url": "https://europepmc.org/articles/PMC13687359",
  "id": "58dyqqt3k5rnw",
  "issns": [
    "1123-6337",
    "1128-045X"
  ],
  "landing_url": "https://europepmc.org/article/MED/42907681",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2746|Anorectal Disease Treatments and Outcomes"
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  "openalex": "W7171327003",
  "pdf_url": "https://europepmc.org/articles/PMC13687359?pdf=render",
  "pmcid": "PMC13687359",
  "pmid": "42907681",
  "published": "2026-07-26",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/58dyqqt3k5rnw.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:57Z",
      "native_id": "MED:42907681",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42907681"
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Anorectal Disease Treatments and Outcomes",
      "subfield": "surgery"
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  ],
  "title": "Is hemorrhoidal surgery really unsafe in inflammatory bowel disease? Results from the HEAD-IBD multicenter study on behalf of IG-IBD.",
  "title_text": "Is hemorrhoidal surgery really unsafe in inflammatory bowel disease? Results from the HEAD-IBD multicenter study on behalf of IG-IBD.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:57Z",
  "url": "https://research.draconitic.com/paper/58dyqqt3k5rnw",
  "venue": "Techniques in coloproctology",
  "versions": []
}