Hemorrhoids pp 235-241 | Cite as

Main Advantages of Hemorrhoidectomy

  • Hsien-Lin SimEmail author
  • Kok-Yang Tan
Reference work entry
Part of the Coloproctology book series (COLOPROCT, volume 2)


Surgical therapy provides satisfactory results in comparison to conservative measures especially for grade III and IV hemorrhoids. To date, there are a variety of surgical procedures available to treat hemorrhoids with equivalent success rates. Conventional hemorrhoidectomy aims to remove hemorrhoids, allowing both internal and external components to be excised. This approach has been proven to be the most effective and associated with the most durable results for grade III and IV hemorrhoids. However, the external wounds in the innervated perianal skin pose problems of postoperative pain and wound healing. Hence, oral analgesics and stool softeners are usually prescribed to ameliorate discomfort during postoperative recovery. Various adjuncts such as pharmacotherapy and hemostatic devices have been described to improve short-term outcomes associated with conventional hemorrhoidectomy. These adjuncts would be further discussed in this chapter.


  1. Burch J, Baba-Akbari A, Weatherly H, Fox D, Golder S, Jayne D, Drummond M, Woolacott N (2008) Stapled haemorrhoidectomy (haemorrhoidopexy) for the treatment of haemorrhoids: a systematic review and economic evaluation. Health Technol Assess 12:1–193Google Scholar
  2. Eusebio EB, Graham J, Mody N (1990) Treatment of intractable pruritius ani. Dis Colon Rectum 33:770–772CrossRefPubMedGoogle Scholar
  3. Khubchandani IT (2002) Internal sphincterotomy with hemorrhoidectomy does not relieve pain: a prospective, randomized study. Dis Colon Rectum 45:1452Y7CrossRefGoogle Scholar
  4. Loder PB, Kamm MA, Nicholls RJ, Phillips RK (1994) ‘reversible chemical sphincterotomy’ by local application of glyceryl trinitrate. Br J Surg 81(9):1386–1389CrossRefPubMedGoogle Scholar
  5. Lohsiriwat V (2012) Hemorrhoids: from basic pathophysiology to clinical management. World J Gastroenterol 18:2009–2017CrossRefPubMedPubMedCentralGoogle Scholar
  6. Morinaga K, Hasuda K, Ikeda T (1995) A novel therapy for internal haemorrhoids: ligation of the hemorrhoidal artery with a newly devised instrument (Moricorn) in conjunction with a Doppler flowmeter. Am J Gastroenterol 90:610–613PubMedPubMedCentralGoogle Scholar
  7. Nelson RL (2010) Operative procedures for fissure in ano. Cochrane Database Syst Rev (2):CD002199Google Scholar
  8. Ratnasingham K, Uzzaman M, Andreani SM, Light D, Patel B (2010) Meta-analysis of the use of glyceryl trinitrate ointment after haemorrhoidectomy as an analgesic and in promoting wound healing. Int J Surg 8:606–611CrossRefPubMedGoogle Scholar
  9. Riegler M, Cosentini EP (2004) LigaSure for hemorrhoidectomy. Dis Colon Rectum 47:1557–1558CrossRefPubMedGoogle Scholar
  10. Shao W, Li G, Zhang Z, Yang B, Sun G, Chen Y (2008) Systematic review and meta-analysis of randomized controlled trials comparing stapled haemorrhoidopexy with conventional haemorrhoidectomy. Br J Surg 95(2):147–160CrossRefPubMedGoogle Scholar
  11. Sim H-L, Tan K-Y (2014) Randomized single-blind clinical trial of intradermal methylene blue on pain reduction after open diathermy haemorrhoidectomy. Color Dis 16:283–287CrossRefGoogle Scholar
  12. Tan KY, Sng KK, Tay KH, Lai JH, Eu KW (2006) Randomised clinical trial of 0.2 per cent glyceryl trinitrate ointment for wound healing and pain reduction after open diathermy haemorrhoidectomy. Br J Surg 93(12):1464–1468CrossRefPubMedGoogle Scholar
  13. Tan K-Y, Zin T, Sim H-L, Poon P-L, Cheng A, Mak K (2008) Randomized controlled trial of LigaSure hemorrhoidectomy with open diathermy hemorrhoidectomy. Tech Coloproctol 12:93–97CrossRefPubMedPubMedCentralGoogle Scholar
  14. Wasvary HJ, Hain J, Mosed-Vogel M, Bendick P, Barkel DC, Klein SN (2001) Randomised, prospective, double-blind, placebo controlled trial of effect of nitroglycerin ointment on pain after haemorrhoidectomy. Dis Colon Rectum 44:1069Y73CrossRefGoogle Scholar
  15. 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 haemorrhoids: a meta-analysis of randomised control trials. Tech Coloproctol 20:825–833CrossRefPubMedGoogle Scholar

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© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Colorectal Service, Department of SurgeryKhoo Teck Puat HospitalSingaporeSingapore

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