Advertisement

Hemorrhoids pp 209-213 | Cite as

Why and When I Do Prefer the Hemorrhoidectomy

  • Mario Trompetto
  • Paola Campennì
Reference work entry
Part of the Coloproctology book series (COLOPROCT, volume 2)

Abstract

Over the years, numerous techniques, more or less invasive, have been proposed for the treatment of hemorrhoids. In cases of failure of conservative therapy, or in advanced hemorrhoidal disease, surgical treatment is necessary. Therapeutic choice is guided by an accurate clinical examination and symptoms severity. Conventional hemorrhoidectomy is the standard surgical treatment for advanced hemorrhoidal disease, although it is characterized by severe postoperative pain. Currently various modifications of the technique have been introduced to reduce postoperative discomfort. It is indicated in cases of voluminous external prolapse not reducible, necrotic thrombosis, and recurrence. Severe immunodepression, radiation proctitis, and chronic perianal inflammatory disease are considered relative counter-indications and can be discussed individually. Recent studies compared hemorrhoidectomy with minivasive techniques reporting variable results due to short-term follow-up, differences on disease classification, and study population.

References

  1. Arbman G, Krook H, Haapaniemi S (2000) Closed vs open hemorrhoidectomy is there any difference? Dis Colon Rectum 43:31–34CrossRefPubMedPubMedCentralGoogle Scholar
  2. Armstrong DN, Ambroze WL, Schertzer ME, Orangio GR (2001) Harmonic scalpel vs. electrocautery hemorrhoidectomy: a prospective evaluation. Dis Colon Rectum 44:558–564CrossRefPubMedPubMedCentralGoogle Scholar
  3. Carapeti EA, Kamm MA, McDonald PJ, Chadwick SJ, Phillips RK (1999) Randomized trial of open versus closed day-case haemorrhoidectomy. BJS 86:612–613CrossRefGoogle Scholar
  4. Chung CC, Ha JP, Tai YP, Tsang WW, Li MK (2002) Double-blind, randomized trial comparing harmonic scalpel hemorrhoidectomy, bipolar scissors hemorrhoidectomy, and scissors excision: ligation technique. Dis Colon Rectum 45:789–794CrossRefPubMedPubMedCentralGoogle Scholar
  5. Davis RC Jr (1992) Use of Nd:YAG laser therapy for treatment of hemorrhoidal disease. Clin Laser Mon 10:161–162PubMedGoogle Scholar
  6. Eu KW, Seow-Choen F, Goh HS (1994) Comparison of emergency and elective haemorrhoidectomy. BJS 81:308–310CrossRefGoogle Scholar
  7. Ferguson JA, Mazier WP, Ganchrow MI, Friend WG (1971) The closed technique of hemorrhoidectomy. Surgery 70:480–484PubMedPubMedCentralGoogle Scholar
  8. Ho YH, Seow-Choen F, Tan M, Leong AF (1997) Randomized controlled trial of open and closed haemorrhoidectomy. Br J Surg 84:1729–1730CrossRefPubMedGoogle Scholar
  9. Hodgson WJ, Morgan J (1995) Ambulatory hemorrhoidectomy with CO2 laser. Dis Colon Rectum 38:1265–1269CrossRefPubMedGoogle Scholar
  10. Ibrahim S, Tsang C, Lee YL, KW E, Seow-Choen F (1998) Prospective, randomized trial comparing pain and complications between diathermy and scissors for closed hemorrhoidectomy. Dis Colon Rectum 41:1418–1420CrossRefPubMedPubMedCentralGoogle Scholar
  11. Kaidar-Person O, Person B, Wexner SD (2007) Hemorrhoidal disease: a comprehensive review. J Am Coll Surg 204(1):102–117CrossRefPubMedGoogle Scholar
  12. Khan S, Pawlak SE, Eggenberger JC, Lee CS, Szilagy EJ, Wu JS, Margolin DA (2001) Surgical treatment of hemorrhoids: prospective, randomized trial comparing closed excisional hemorrhoidectomy and the harmonic scalpel technique of excisional hemorrhoidectomy. Dis Colon Rectum 44:845–849CrossRefPubMedGoogle Scholar
  13. Loder PB, Phillips RK (1993) Haemorrhoidectomy. Current Prac Surg 5:29–35Google Scholar
  14. Milligan ETC, Morgan CN, Jones LE, Ofcer R (1937) Surgical anatomy of the anal canal, and the operative treatment of haemorrhoids. Lancet 2:1119–1124CrossRefGoogle Scholar
  15. Nienhuijs S, de Hingh I (2009) Conventional versus LigaSure hemorrhoidectomy for patients with symptomatic hemorrhoids. Cochrane Database Syst Rev 21:CD006761Google Scholar
  16. Parks AG (1956) The surgical treatment of haemorrhoids. BJS 43:337–351CrossRefGoogle Scholar
  17. Senagore A, Mazier WP, Luchtefeld MA, MacKeigan JM, Wengert T (1993) Treatment of advanced hemorrhoidal disease: a prospective, randomized comparison of cold scalpel vs. contact Nd:YAG laser. Dis Colon Rectum 36:1042–1049CrossRefPubMedGoogle Scholar
  18. Seow-Choen F, Ho YH, Ang HG, Goh HS (1992) Prospective, randomized trial comparing pain and clinical function after conventional scissors excision/ligation vs. diathermy excision without ligation for symptomatic prolapsed hemorrhoids. Dis Colon Rectum 35:1165–1169CrossRefPubMedGoogle Scholar
  19. Sharif HI, Lee L, Alexander-Williams J (1991) Diathermy haemorrhoidectomy. Int J Color Dis 6:217–219CrossRefGoogle Scholar
  20. Simillis C, Thoukididou SN, Slesser AAP, Rasheed S, Tan E, Tekkis PP (2015) Systematic review and network meta-analysis comparing clinical outcomes and effectiveness of surgical treatments for haemorrhoids. BJS 102:1603–1618CrossRefGoogle Scholar
  21. Tan JJ, Seow-Choen F (2001) Prospective, randomized trial comparing diathermy and harmonic scalpel hemorrhoidectomy. Dis Colon Rectum 44:677–679CrossRefPubMedPubMedCentralGoogle Scholar
  22. Trompetto M, Clerico G, Cocorullo GF, Giordano P, Marino F, Martellucci J, Milito G, Mistrangelo M, Ratto C (2015) Evaluation and management of hemorrhoids: Italian society of colorectal surgery (SICCR) consensus statement. Tech Coloproctol 19:567–575CrossRefPubMedPubMedCentralGoogle Scholar
  23. Wang JY, Chang-Chien CR, Chen JS, Lai CR, Tang RP (1991) The role of lasers in hemorrhoidectomy. Dis Colon Rectum 34:78–82CrossRefPubMedGoogle Scholar
  24. Whitehead W (1887) Three hundred cases of haemorrhoids cured by excision. Br Med J 1:449–451CrossRefPubMedPubMedCentralGoogle Scholar
  25. Xu L, Chen H, Lin G, Ge Q, Qi H, He X (2016) Transanal hemorrhoidal dearterialization with mucopexy versus open hemorrhoidectomy in the treatment of hemorrhoids: a meta-analysis of randomized control trials. Tech Coloproctol 20:825–833CrossRefPubMedPubMedCentralGoogle Scholar
  26. You SY, Kim SH, Chung CS, Lee DK (2005) Open versus closed hemorrhoidectomy. Dis Colon Rectum 48:108–113CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Colorectal SurgeryS. Rita ClinicVercelliItaly
  2. 2.Division of Colon and Rectal SurgeryHumanitas Clinical and Research CenterRozzano MilanItaly

Personalised recommendations