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Clinical Outcome Following Hemorrhoid Surgery: a Narrative Review

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Abstract

Surgical therapy guaranties satisfactory results, which are significantly better than those obtained with conservative therapies, especially for Grade III and IV hemorrhoids. In this review, we present and discuss the results of the most diffuse surgical techniques for hemorrhoids. Traditional surgery for hemorrhoids aims to remove the hemorrhoids, with closure (Fergusson’s technique) or without closure (Milligan–Morgan procedure) of the ensuing defect. This traditional approach is effective, but causes a significant postoperative pain because of wide external wounds in the innervated perianal skin. Stapled hemorrhoidopexy, proposed by Longo, has gained a vast acceptance because of less postoperative pain and faster return to normal activities. In the recent literature, a significant incidence of recurrence after stapled hemorrhoidopexy was reported, when compared with conventional hemorrhoidectomy. Double stapler hemorrhoidopexy may be an alternative to simple stapled hemorrhoidopexy to reduce the recurrence in advanced hemorrhoidal prolapse. Transanal hemorrhoidal deartertialization was showed to be as effective as stapled hemorrhoidopexy in terms of treatment success, complications, and incidence recurrence. However, further high-quality trials are recommended to assess the efficacy and safety of this technique.

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Authors and Affiliations

  1. Department of Surgery, Civil Hospital “P. Colombo”, Via Orti Ginnetti 7, 00049, Velletri, Rome, Italy

    Marcello Picchio, Ettore Greco & Giuseppe Marino

  2. Department of Surgery, Hospital “S. Giovanni-Addolorata”, Via dell’Amba Aradam 9, 00184, Rome, Italy

    Francesco Stipa

  3. Department of Surgery, Sapienza University of Rome, Polo Pontino Via Firenze, s.n.c., 04019, Terracina, Latina, Italy

    Annalisa Di Filippo & Erasmo Spaziani

  4. Via Giulio Cesare, n. 58, 04100, Latina, Italy

    Marcello Picchio

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Picchio, M., Greco, E., Di Filippo, A. et al. Clinical Outcome Following Hemorrhoid Surgery: a Narrative Review. Indian J Surg 77 (Suppl 3), 1301–1307 (2015). https://doi.org/10.1007/s12262-014-1087-5

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