Advertisement

Wiener klinische Wochenschrift

, Volume 124, Issue 5–6, pp 207–219 | Cite as

Konsensusbericht Hämorrhoidalleiden

  • Felix AignerEmail author
  • Friedrich Conrad
  • Ingrid Haunold
  • Johann Pfeifer
  • Andreas Salat
  • Max Wunderlich
  • Konsensusgruppe der Arbeitsgemeinschaft für Coloproktologie (ACP) der Österreichischen Gesellschaft für Chirurgie
  • Rene Fortelny
  • Helga Fritsch
  • Markus Glöckler
  • Hubert Hauser
  • Andreas Heuberger
  • Judith Karner-Hanusch
  • Christoph Kopf
  • Peter Lechner
  • Stefan Riss
  • Sebastian Roka
  • Matthias Scheyer
konsensusbericht

Zusammenfassung

Das Hämorrhoidalleiden zählt zu den häufigsten gutartigen Erkrankungen des unteren Verdauungstraktes und tritt oft als Begleiterscheinung anderer auch bösartiger Erkrankungen auf. Die Therapie reicht von konservativen bis hin zu chirurgischen Eingriffen, die nach wie vor willkürlich und abhängig von der Präferenz und der Expertise des jeweiligen Chirurgen angewandt werden. Das Ziel dieses Konsensusberichtes war es daher, anhand der Literatur eine stadiengerechte Therapie des Hämorrhoidalleidens zu definieren und evidenz-basierte Empfehlungen der Fachgesellschaft für die klinische Routine abzuleiten. Die gängigsten Methoden werden unter Berücksichtigung des Hämorrhoidalleidens in speziellen Situationen wie der Schwangerschaft oder chronisch entzündlicher Darmerkrankungen sowie dem rezidivierenden Hämorrhoidalleiden diskutiert. Die maßgeschneiderte Hämorrhoidenbehandlung ist für den individuellen Fall wünschenswert gerade in Hinblick auf die Unzulänglichkeiten der traditionellen Goligher Klassifikation bei der Unterscheidung zwischen solitärem oder zirkulärem Hämorrhoidalprolaps.

Schlüsselwörter

Hämorrhoidalleiden Ätiologie Behandlung Maßgeschneiderte Hämorrhoidektomie Rezidiv 

Consensus statement haemorrhoidal disease

Summary

Haemorrhoidal disease belongs to the most common benign disorders in the lower gastrointestinal tract. Treatment options comprise conservative as well as surgical therapy still being applied arbitrarily in accordance with the surgeon's expertise. The aim of this consensus statement was therefore to assess a stage-dependent approach for treatment of haemorrhoidal disease to derive evidence-based recommendations for clinical routine. The most common methods are discussed with respect of haemorrhoidal disease in extraordinary conditions like pregnancy or inflammatory bowel disease and recurrent haemorrhoids. Tailored haemorrhoidectomy is preferable for individualized treatment with regard to the shortcomings of the traditional Goligher classification in solitary or circular haemorrhoidal prolapses.

Keywords

Haemorrhoidal disease Aetiology Treatment Tailored haemorrhoidectomy Recurrence 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literaturverzeichnis

  1. Faccini M, Zuccon W, Caputo P, et al. Hemorrhoids: epidemiology and correlation with chronic constipation. Ann Ital Chir 2001;72:337–9PubMedGoogle Scholar
  2. Cataldo P, Ellis N, Gregorcyk S, et al. The American Society of Colon and Rectal Surgeons. Practice Parameters for the Management of Hemorrhoids (Revised). Dis Colon Rectum 2005;48:189–94PubMedGoogle Scholar
  3. Müller-Lobeck H. Ambulante Hämorrhoidaltherapie. Chirurg 2001;72:667–76PubMedGoogle Scholar
  4. Nyström PO, Gerjy R. Coloproctology. European Manual of Medicine. 1. Auflage. Springer-Verlag Berlin Heidelberg; 2008. Kapitel Haemorrhoids; p. 35Google Scholar
  5. Hansen HH. The importance of the Musculus canalis ani for continence and anorectal diseases. Langenbecks Arch Chir 1976;341:23–37PubMedGoogle Scholar
  6. Stelzner F, Staubesand J, Machleidt H. The corpus cavernosum recti--basis of internal hemorrhoids. Langenbecks Arch Klin Chir Ver Dtsch Z Chir 1962;299:302–12PubMedGoogle Scholar
  7. Widmer O. Rectal arteries in man; entrance, caliber, distribution, anastomosis and supply area. Z Anat Entwicklungsgesch 1955;118:398–416PubMedGoogle Scholar
  8. Thomson WH. The nature of haemorrhoids. Br J Surg 1975;62:542–52.PubMedGoogle Scholar
  9. Loder PB, Kamm MA, Nicholls RJ, Phillips RKS. Haemorrhoids: pathology, pathophysiology and aetiology. Br J Surg 1994;81:946–54PubMedGoogle Scholar
  10. Aigner F, Bodner G, Gruber H, et al. The vascular nature of hemorrhoids. J Gastrointest Surg. 2006;10(7):1044–50PubMedGoogle Scholar
  11. Aigner F, Gruber H, Conrad F, et al. Revised morphology and hemodynamics of the anorectal vascular plexus: impact on the course of hemorrhoidal disease. Int J Colorectal Dis 2009;24(1):105–13PubMedGoogle Scholar
  12. Wienert V, Mlitz H, Raulf F. Handbuch Hämorrhoidalleiden. 1. Auflage. Uni-Med Verlag AG Bremen; 2008. Kapitel Hämorrhoiden; pp. 11–3Google Scholar
  13. Wald A. Constipation, diarrhea, and symptomatic hemorrhoids during pregnancy. Gastroenterol Clin North Am 2003;32:309–22PubMedGoogle Scholar
  14. Johannsson HO, Graf W, Pahlman L. Bowel habits in hemorrhoid patients and normal subjects. Am J Gastroenterol 2005;100:401–6PubMedGoogle Scholar
  15. Johanson JF, Sonnenberg A. Constipation is not a risk factor for hemorrhoids: A case-control study of potential etiological agents. Am J Gastroenterol 1994;89:1981–6PubMedGoogle Scholar
  16. Deutsch AA, Moshkovitz M, Nudelman I, et al. Anal pressure measurements in the study of hemorrhoid etiology and their relation to treatment. Dis Colon Rectum 1987;30:855–7PubMedGoogle Scholar
  17. Sardinha TC, Corman ML. Hemorrhoids. Surg Clin North Am 2002;82:1153–67PubMedGoogle Scholar
  18. Acheson RM. Haemorrhoids in the adult male: a small epidemiological study. Guys Hospital Reports 1960;109:184–95Google Scholar
  19. Chung YC, Hou YC, Pan AC. Endoglin (CD 105) expression in the development of haemorrhoids. Eur J Clin Invest 2004;34:107–12PubMedGoogle Scholar
  20. Delco F, Sonnenberg A. Association between hemorrhoids and other diagnoses. Dis Colon Rectum 1998;41:1534–42PubMedGoogle Scholar
  21. Goligher JC (ed.). Surgery of the anus, rectum and colon. 5. Auflage. W. B. Saunders; 1983Google Scholar
  22. Aigner F, Bodner G, Conrad F, Mbaka G, Kreczy A, Fritsch H. The superior rectal artery and its branching pattern with regard to its clinical influence on ligation techniques for internal hemorrhoids. Am J Surg 2004;187(1):102–8PubMedGoogle Scholar
  23. La Torre F, Nicolai AP. Clinical use of micronized purified flavonoid fraction for treatment of symptoms after hemorrhoidectomy: Results of a randomized, controlled, clinical trial. Dis Colon Rectum 2004;47:704–10PubMedGoogle Scholar
  24. Misra MC, Parshad R. Randomized clinical trial of micronized purified flavonoids in the early control of bleeding from acute internal haemorrhoids. Br J Surg 2000;87:868–72PubMedGoogle Scholar
  25. Godeberge Ph. Daflon 500 mg is significantly more effective than Placebo in the treatment of haemorrhoids. Phlebology 1992;(Suppl. 2):61–3Google Scholar
  26. Cospite M. Double-blind, Placebo-controlled evaluation of clinical activity and safety of Daflon 500 mg in the treatment of acute hemorrhoids. Angiology 1994;45:566–73PubMedGoogle Scholar
  27. Jiang Z-M, Cao J-D. The impact of micronized purified flavonoid fraction on the treatment of acute haemorrhoidal episodes. Curr Med Res Opin 2006;22:1141–7PubMedGoogle Scholar
  28. Dimitroulopoulos D, Tsamakidis K, Xinopoulos D, Karaitianos I, Fotopoulou A, Paraskevas E. Prospective, Randomized, Controlled, Observer-Blinded Trial of Combined Infrared Photocoagulation and Micronized Purified Flavonoid Fraction Versus each alone for the Treatment of Hemorrhoidal Disease. Clin Ther 2005;27:746–54PubMedGoogle Scholar
  29. Ho YH, Tan M, Seow-Choen F. Micronized purified flavonidic fraction compared favorably with rubber band ligation and fiber alone in the management of bleeding hemorrhoids: randomized controlled trial. Dis Colon Rectum 2000;43(1):66–9PubMedGoogle Scholar
  30. Ho YH, Foo CL, Seow-Choen F, Goh HS. Prospective randomized controlled trial of a micronized flavonidic fraction to reduce bleeding after haemorrhoidectomy. Br J Surg 1995;82(8):1034–5PubMedGoogle Scholar
  31. Blanchard C. Text book of ambulant proctology. Medical success press. Ohio; 1928Google Scholar
  32. MacRae H. Comparison of hemorrhoidal treatment modalities; a meta-analysis. Dis Colon Rectum 1995;38;687–94PubMedGoogle Scholar
  33. Blaisdell PC. Scientific Exhibit. American Medical Association; 1954Google Scholar
  34. Barron J. Office ligation treatment of hemorrhoids. Dis Colon Rectum 1963;6:109–13PubMedGoogle Scholar
  35. Scarpa FJ. Pelvic cellulitis: A life-threatening complication of hemorrhoidal banding. Surgery 1988;103:383–5PubMedGoogle Scholar
  36. Marshman D, Huber PJ Jr, Timmerman W, Simonton CT, Odom FC, Kaplan ER. Hemorrhoidal ligation. A review of efficacy. Dis Colon Rectum 1989;32(5):369–71PubMedGoogle Scholar
  37. Mattana C, Maria G, Pescatori M. Rubber band ligation of hemorrhoids and rectal mucosal prolapse in constipated patients. Dis Colon Rectum 1989;32(5):372–5PubMedGoogle Scholar
  38. Spallanzani A, Ricchi E, Carriero A, Fundarò S, Perrone S, Pezcoller C. Rubber band ligation of hemorrhoids. Our experience. Minerva Chir 1997;52(9):1047PubMedGoogle Scholar
  39. Johanson JF. Optimal nonsurgical treatment of hemorrhoids: a comparative analysis of infrared, rubber band ligation and injection sclerotherapy. Am J Gastroenterol 1992;87;1600PubMedGoogle Scholar
  40. Giamundo P, Cecchetti W, Esercizio L, et al. Doppler-guided hemorrhoidal laser procedure for the treatment of symptomatic hemorrhoids: experimental background and short-term clinical results of a new mini-invasive treatment. Surg Endosc 2011;25(5):1369–75PubMedGoogle Scholar
  41. Plapler H, Hage R, Duarte J, et al. A new method for hemorrhoid surgery: intrahemorrhoidal diode laser, does it work? Photomed Laser Surg 2009;27(5):819–23PubMedGoogle Scholar
  42. Konsten J, Baeten CG. Hemorrhoidectomy vs. Lord's method: 17-year follow-up of a prospective, randomized trial. Dis Colon Rectum 2000;43(4):503–6PubMedGoogle Scholar
  43. Oliver DW, Booth MW, Kernick VF, Irvin TT, Campbell WB. Patient satisfaction and symptom relief after anal dilatation. Int J Colorectal Dis 1998;13(5–6):228–31PubMedGoogle Scholar
  44. MacDonald A, Smith A, McNeill AD, Finlay IG. Manual dilatation of the anus. Br J Surg. 1992;79(12):1381–2PubMedGoogle Scholar
  45. Nielsen MB, Rasmussen OO, Pedersen JF, Christiansen J. Risk of sphincter damage and anal incontinence after anal dilatation for fissure-in-ano. An endosonographic study. Dis Colon Rectum 1993l;36(7):677–80Google Scholar
  46. Morinaga K, Hasuda K, Ikeda T. A novel therapy for internal hemorrhoids: ligation of the hemorrhoidal artery with a newly devised instrument (Moricorn) in conjunction with a Doppler flowmeter. Am J Gastroenterol 1995;90(4):610–3PubMedGoogle Scholar
  47. Farag AE. Pile suture: a new technique for the treatment of haemorrhoids. Br J Surg 1978;65(4):293–5PubMedGoogle Scholar
  48. Hussein M. Ligation-anopexy for treatment of advanced hemorrhoidal disease. Dis Colon Rectum 2001;44(12):1887–90PubMedGoogle Scholar
  49. Theodoropoulos GE, Sevrisarianos N, Papaconstantinou J, et al. Doppler-guided haemorrhoidal artery ligation, rectoanal repair, sutured haemorrhoidopexy and minimal mucocutaneous excision for grades III–IV haemorrhoids: a multicenter prospective study of safety and efficacy. Colorectal Dis 2010;12(2):125–34PubMedGoogle Scholar
  50. Scheyer M, Antonietti E, Rollinger G, Mall H, Arnold S. Doppler-guided hemorrhoidal artery ligation. Am J Surg 2006;191:89–93PubMedGoogle Scholar
  51. Dal Monte PP, Tagariello C, Giordano P, et al. Transanal haemorrhoidal dearterialisation: nonexcisional surgery for the treatment of haemorrhoidal disease. Tech Coloproctol 2007;11:333–9PubMedGoogle Scholar
  52. Bursics A, Morvay K, Kupcsulik P, Flautner L. Comparison of early and 1-year follow-up results of conventional hemorrhoidectomy and hemorrhoid artery ligation: a randomized study. Int J Colorectal Dis 2004;19(2):176–80PubMedGoogle Scholar
  53. Infantino A, Bellomo R, Dal Monte PP, et al. Transanal Haemorrhoidal Artery Echodoppler Ligation and anopexy (THD) is effective for II and III degree haemorrhoids: a prospective multicentric study. Colorectal Dis 2010;12(8):804–9PubMedGoogle Scholar
  54. Zagryadskiy AE, Gorelov SI. Transanal Doppler-guided hemorrhoidal Artery ligation/recto anal repair (HAL-RAR®) for treatment of Grade 3-4 hemorrhoids: a new mini-invasive technology. Pelviperineology 2008;27:151–5.Google Scholar
  55. Walega P, Krokowicz P, Romaniszyn M, et al. Doppler Guided Haemorrhoidal Arterial Ligation with recto-anal-repair (RAR) for the treatment of advanced haemorrhoidal disease. Colorectal Dis [Internet] 2010;12(10 Online):e326–9Google Scholar
  56. Koblandin SN, Schalkow JL. Eine neue Methode zur Behandlung von Hämorrhoiden mit Hilfe eines Zirkularstaplers. Zelinograd/Kasachstan: Wissenschaftliches Institut des Zelinograder Medizinischen Institutes 1981; pp. 27–8Google Scholar
  57. Kusobenko MJ. Resektion von inneren Hämorrhoiden mit Hilfe eines Zirkularstaplers. Akademie für Ärztliche Weiterbildung Charkow/Ukraine: Dissertation 1991Google Scholar
  58. Longo A. Treatment of haemorrhoidal disease by reduction of mucosa and haemorrhoidal prolapse with a circular suturing device: A new procedure. Proceedings of the 6th World Congress of Endoscopic Surgery, Rome, Monduzzi Editore, Bologna 1998;777–84Google Scholar
  59. Tjandra JJ, Chan KJ. Systematic Review on the Procedure for Prolapse and Hemorrhoids (Stapled Hemorrhoidopexy). Dis Colon Rectum 2007;50:878–92PubMedGoogle Scholar
  60. Shao WJ, Li GC, Zhang HK, Yang BL, Sun GD, Chen YQ. Systematic review and meta-analysis of randomizes controlled trials comparing stapled haemorrhoidopexy with conventional haemorrhoidectomy. Br J Surg 2008;95:147–60PubMedGoogle Scholar
  61. Aigner F, Conrad F. Chirurgie, Heft 3/2007. P.P.H. (Procedure for Prolapse and Haemorrhoids) - Die Staplerhämorrhoidopexie 2007; pp. 21–3Google Scholar
  62. Herold A. Stadienadaptierte Therapie des Hämorrhoidalleidens. Chirurg 2008;79:418–29PubMedGoogle Scholar
  63. Altomare DF, Roveran A, Pecorella G, Gaj F, Stortini E. The treatment of hemorrhoids: guidelines of the Italian Society of Colo-Rectal Surgery. Tech Coloproctol 2006;10:181–6PubMedGoogle Scholar
  64. Cirocco WC. Life threatening sepsis and mortality following stapled hemorrhoidopexy. Surgery 2008;143(6):824–9PubMedGoogle Scholar
  65. Müller-Lobeck H. Chirurgische Allgemeine Zeitung, 1. Jahrgang, Heft 3, 4, Fallstricke der Stapler-Hämorrhoidektomie; pp. 121–5Google Scholar
  66. Pescatori M, Aigner F. Stapled transanal mucosectomy ten years after. Tech Coloproctol 2007:111–6Google Scholar
  67. Wong L, Jiang JK, Chang SC, Lin JK. Rectal perforation: a life- threatening complication of stapled hemorrhoidectomy: report of a case. Dis Colon Rectum 2003;46:116–7PubMedGoogle Scholar
  68. Jayaraman S, Colquhoun PHD, Malthaner RA. Stapled versus conventional surgery of hemorrhoids. Cochrane Database of Systematic Reviews 4, 2006, Art.No.: CD005393. DOI:  101002/14651858.CD005393.pub2
  69. Gonohe T. Surgery of hemorrhoid--transition from Whitehead's method to the ligation and resection method. Shujutsu 1967;21(5):443–50.PubMedGoogle Scholar
  70. Sakr MF. LigaSure versus Milligan-Morgan hemorrhoidectomy: a prospective randomized clinical trial. Tech Coloproctol 2010;14(1):13–7PubMedGoogle Scholar
  71. Milligan ETC, Morgan CN, Jones LE, Officer R. Surgical anatomy of the anal canal and the operative treatment of haemorrhoids. Lancet 1937;1119–24Google Scholar
  72. Parks AG. Hemorrhoidectomy. Surg Clin North Am 1965;1305–15Google Scholar
  73. Ferguson JA, Mazier WP, Ganchrow MI, Friend WG. The closed technique of hemorrhoidectomy. Surgery 1971;70:480–4PubMedGoogle Scholar
  74. Jóhannsson HÖ, Påhlman L, Graf W. Randomized clinical trial of the effects on anal function of Milligan-Morgan versus Ferguson haemorrhoidectomy. Br J Surg 2006;93:1208–14PubMedGoogle Scholar
  75. Burgard GM. Die MISSH (minimal invasive subanodermale submuköse Hämorrhoidoplastie mit supraanalem Lifting) – ein neues operatives Verfahren zur Korrektur auch fixierter Hämorrhoidal- und Analprolapsformen ohne Anoderminzision (Erste Ergebnisse an 614 Patienten). Coloproctology 2005;27:85–95Google Scholar
  76. AWMF. Prophylaxe der venösen Thromboembolie (VTE). Version 18.3.2009; S3-Leitlinie. AWMF Leitlinien-Register Nr. 003/001:50–4Google Scholar
  77. Wunderlich M, Stieböck C, Tentschert G. Chirurgie, Heft 3/2007. Therapie bei Rezidiv oder Komplikationen nach Behandlung des HaemorrhoidalleidensGoogle Scholar
  78. Marti MC, Givel JC (eds.). Surgical management of anorectal and colonic diseases. Springer Verlag Berlin Heidelberg 1998Google Scholar
  79. Martinsons A, Narbuts Z, Brunenieks I, Pavars M, Lebedkovs S, Gardovskis J. A comparison of quality of life and postoperative results from combined PPH and conventional haemorrhoidectomy in different cases of haemorrhoidal disease. Colorectal Disease 2007;9:423–9PubMedGoogle Scholar
  80. Accarpio G, Ballari F, Puglisi R, et al. Outpatient treatment of hemorrhoids with a combined technique: results in 7850 cases. Tech Coloproctol 2002;6(3):195–6PubMedGoogle Scholar
  81. Carapeti EA, Kamm MA, McDonald PJ, Phillips RK. Double-blind randomised controlled trial of effect of metronidazole on pain after day-case haemorrhoidectomy. Lancet 1998;351(9097):169–72PubMedGoogle Scholar
  82. Ala S, Saeedi M, Eshghi F, Mirzabeygi P. Topical metronidazole can reduce pain after surgery and pain on defecation in postoperative hemorrhoidectomy. Dis Colon Rectum 2008;51(2):235–8PubMedGoogle Scholar
  83. Balfour L, Stojkovic SG, Botterill ID, Burke DA, Finan PJ, Sagar PM. A randomized, double-blind trial of the effect of metronidazole on pain after closed hemorrhoidectomy. Dis Colon Rectum 2002;45(9):1186–90PubMedGoogle Scholar
  84. Wesarachawit W, Pattanaarun J. Antibiotics and early post operative complications of closed hemorrhoidectomy: a retrospective matched pair study. J Med Assoc Thai 2007;90(9):1828–32PubMedGoogle Scholar
  85. Roxas MF, Delima MG. Randomized controlled trial to determine the effectiveness of the Nivatvongs technique versus conventional local anaesthetic infiltration for outpatient haemorrhoidectomy. Asian J Surg 2006;29(2):70–3PubMedGoogle Scholar
  86. Gerjy R, Lindhoff-Larson A, Sjödahl R, Nyström PO. Randomized clinical trial of stapled haemorrhoidopexy performed under local perianal block versus general anaesthesia. Br J Surg 2008;95(11):1344–51PubMedGoogle Scholar
  87. Aphinives P. Perianal block for ambulatory hemorrhoidectomy, an easy technique for general surgeon. Med Assoc Thai 2009;92(2):195–7Google Scholar
  88. Karanlik H, Akturk R, Camlica H, Asoglu O. The effect of glyceryl trinitrate ointment on posthemorrhoidectomy pain and wound healing: results of a randomized, double-blind, placebo-controlled study. Dis Colon Rectum 2009;52(2):280–5PubMedGoogle Scholar
  89. Tjandra JJ, Tan JJ, Lim JF, Murray-Green C, Kennedy ML, Lubowski DZ. Rectogesic (glyceryl trinitrate 0.2%) ointment relieves symptoms of haemorrhoids associated with high resting anal canal pressures. Colorectal Dis 2007;9(5):457–63PubMedGoogle Scholar
  90. Patti R, Almasio PL, Arcara M, et al. Botulinum toxin vs. topical glyceryl trinitrate ointment for pain control in patients undergoing hemorrhoidectomy: a randomized trial. Dis Colon Rectum 2007;50(1):122Google Scholar
  91. Chauhan A, Tiwari S, Mishra VK, Bhatia PK. Comparison of internal sphincterotomy with topical diltiazem for post-hemorrhoidectomy pain relief: a prospective randomized trial. J Postgrad Med 2009;55(1):22–6PubMedGoogle Scholar
  92. Thaha MA, Irvine LA, Steele RJ, Campbell KL. Postdefaecation pain syndrome after circular stapled anopexy is abolished by oral nifedipine. Br J Surg 2005;92(2):208–10PubMedGoogle Scholar
  93. Alonso-Coello P, Zhou Q, Martinez-Zapata MJ, et al. Meta-analysis of flavonoids for the treatment of haemorrhoids. Br J Surg 2006;93(8):909–20PubMedGoogle Scholar
  94. Gupta PJ, Heda PS, Kalaskar S, Tamaskar VP. Topical sucralfate decreases pain after hemorrhoidectomy and improves healing: a randomized, blinded, controlled study. Dis Colon Rectum 2008;51(2):231–4PubMedGoogle Scholar
  95. Milsom J. Fundamentals of Anorectal Surgery. McGraw-Hill Inc. New York. Kapitel Hemorrhoidal Disease 1992; pp. 192–214Google Scholar
  96. Koh DC, Cheong DM, Wong KS. Stapled haemorrhoidectomy: bothersome staple line bleeding. Asian J Surg 2005;28(3):193–7PubMedGoogle Scholar
  97. Rosen L, Sipe P, Stasik JJ, Riether RD, Trimpi HD. Outcome of delayed hemorrhage following surgical hemorrhoidectomy. Dis Colon Rectum 1993;36(8):743–6PubMedGoogle Scholar
  98. Deen KI, Wong WD. Complications of Colon & Rectal Surgery. Williams & Wilkins Baltimore. Kapitel Hemorrhoidal Surgery 1996; pp.163–72Google Scholar
  99. Toyonaga T, Matsushima M, Sogawa N, et al. Postoperative urinary retention after surgery for benign anorectal disease: potential risk factors and strategy for prevention. Int J Colorectal Dis 2006;21(7):676–82PubMedGoogle Scholar
  100. Bleday R, Pena JP, Rothenberger DA, Goldberg SM, Buls JG. Symptomatic hemorrhoids: current incidence and complications of operative therapy. Dis Colon Rectum 1992;35(5):477–81PubMedGoogle Scholar
  101. Alonso-Coello P, Mills E, Heels-Ansdell D, et al. Fiber for the treatment of hemorrhoids complications: a systematic review and meta-analysis. Am J Gastroenterol 2006;101(1):181–8PubMedGoogle Scholar
  102. Brusciano L, Ayabaca SM, Pescatori M, et al. Reinterventions after complicated or failed stapled hemorrhoidopexy. Dis Colon Rectum 2004;47(11):1846–51PubMedGoogle Scholar
  103. McCloud JM, Jameson JS, Scott AN. Life-threatening sepsis following treatment for haemorrhoids: a systematic review. Colorectal Dis 2006;8(9):748–55PubMedGoogle Scholar
  104. Sarkis P, Farran F, Khoury R, et al. Fournier's gangrene: a review of the recent literature. Prog Urol 2009;19(2):75–84PubMedGoogle Scholar
  105. Corcoran AT, Smaldone MC, Gibbons EP, Walsh TJ, Davies BJ. Validation of the Fournier's gangrene severity index in a large contemporary series. J Urol 2008;180(3):944–8PubMedGoogle Scholar
  106. Brisinda G, Vanella S, Cadeddu F, et al. Surgical treatment of anal stenosis. World J Gastroenterol. 2009;15(16):1921–8PubMedGoogle Scholar
  107. Pfeifer J, Reissman P, Gonzales A, Nogueras JJ, Wexner SD. "House" flap procedure for anal stenosis. Techniques and results. Tech Coloproctol 1995;3(2):62–5Google Scholar
  108. Ommer A, Wenger FA, Rolfs T, Walz MK. Continence disorders after anal surgery--a relevant problem? Int J Colorectal Dis 2008;23(11):1023–31PubMedGoogle Scholar
  109. Holzheimer RG. Hemorrhoidectomy: indications and risks. Eur J Med Res 2004;9(1):18–36PubMedGoogle Scholar
  110. Ceulemnans R, Creve U, Van Hee R, Martens C, Wuyts FL. Benefit of emergency haemorrhoidectomy: a comparison with results after elective operations. Eur J Surg 2000;166(10):808–12Google Scholar
  111. Gonzalez-Ruiz C, Heartfield W, Briggs B, Vukasin P, Beart RW. Anorectal pathology in HIV/AIDS-infected patients has not been impacted by highly active antiretroviral therapy. Dis Colon Rectum 2004;47(9):1483–6PubMedGoogle Scholar
  112. Staroselsky A, Nava-Ocampo AA, Vohra S, Koren G. Hemorrhoids in pregnancy. Can Fam Physician 2008;54(2):189–90PubMedGoogle Scholar
  113. Quijano CE, Abalos E. Conservative management of symptomatic and/or complicated haemorrhoids in pregnancy and the puerperium. Cochrane Database Syst Rev 2005;3:CD004077PubMedGoogle Scholar
  114. Williams A, Herron-Marx S, Knibb R. The prevalence of enduring postnatal perineal morbidity and its relationship to type of birth and birth risk factors. J Clin Nurs 2007;16(3):549–61PubMedGoogle Scholar
  115. White I, Avital S, Greenberg R. Outcome of repeated stapler hemorrhoidopexy for recurrent prolapsing hemorrhoids. Colorectal Dis 2011;13(9):1048–51PubMedGoogle Scholar
  116. Festen S, van Geloven AA, Gerhards MF. Redo procedure for prolapse and haemorrhoids (PPH) for persistent and recurrent prolapse after PPH. Dig Surg 2009;26(5):418–21PubMedGoogle Scholar
  117. Raahave D, Jepsen LV, Pedersen IK. Primary and repeated stapled hemorrhoidopexy for prolapsing hemorrhoids: follow-up to five years. Dis Colon Rectum 2008;51(3):334–41PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Felix Aigner
    • 1
    Email author
  • Friedrich Conrad
    • 1
  • Ingrid Haunold
    • 2
  • Johann Pfeifer
    • 3
  • Andreas Salat
    • 4
  • Max Wunderlich
    • 2
  • Konsensusgruppe der Arbeitsgemeinschaft für Coloproktologie (ACP) der Österreichischen Gesellschaft für Chirurgie
  • Rene Fortelny
    • 5
  • Helga Fritsch
    • 6
  • Markus Glöckler
    • 7
  • Hubert Hauser
    • 3
  • Andreas Heuberger
    • 8
  • Judith Karner-Hanusch
    • 4
  • Christoph Kopf
    • 9
  • Peter Lechner
    • 10
  • Stefan Riss
    • 4
  • Sebastian Roka
    • 4
  • Matthias Scheyer
    • 11
  1. 1.Univ.-Klinik für Visceral-, Transplantations- und ThoraxchirurgieMedizinische Universität InnsbruckInnsbruckAustria
  2. 2.Krankenhaus der Barmherzigen Schwestern WienWienAustria
  3. 3.Univ.-Klinik für Chirurgie, Klinische Abteilung für AllgemeinchirurgieMedizinische Universität GrazGrazAustria
  4. 4.Univ.-Klinik für Chirurgie, Klinische Abteilung für AllgemeinchirurgieMedizinische Universität WienWienAustria
  5. 5.Abteilung für Allgemein-, Viszeral- und TumorchirurgieWilhelminenspital WienWienAustria
  6. 6.Department für Anatomie, Histologie und Embryologie, Sektion für Klinisch-Funktionelle AnatomieMedizinische Universität InnsbruckInnsbruckAustria
  7. 7.Krankenhaus St. ElisabethWienAustria
  8. 8.Abteilung für Allgemein- und Unfallchirurgiea. ö. Krankenhaus Oberndorf bei SalzburgSalzburgAustria
  9. 9.Chirurgische AbteilungKrankenhaus SchärdingSchärdingAustria
  10. 10.Chirurgische AbteilungLandesklinikum Donauregion TullnTullnAustria
  11. 11.Abteilung für AllgemeinchirurgieLandeskrankenhaus BludenzBludenzAustria

Personalised recommendations