Why and When I Do Prefer the Hemorrhoidectomy
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.
- 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
- Loder PB, Phillips RK (1993) Haemorrhoidectomy. Current Prac Surg 5:29–35Google Scholar
- Nienhuijs S, de Hingh I (2009) Conventional versus LigaSure hemorrhoidectomy for patients with symptomatic hemorrhoids. Cochrane Database Syst Rev 21:CD006761Google Scholar