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Selection of Patients to the Surgical Treatment of Hemorrhoids

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Hemorrhoids

Part of the book series: Coloproctology ((COLOPROCT,volume 2))

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Abstract

Some patients with prominent hemorrhoids will present with symptoms requiring some kind of treatment. Although a majority of patients will be successfully managed by conservative treatment and office procedures, some will need an operation. Surgical indication is mainly settled after failure or contraindication of local treatments or in Grade III and IV hemorrhoids.

Several surgical strategies have been proposed and can be graded by their effectiveness and complications rates. Patients need to be informed on those on the basis of their main symptoms and general and proctologic baseline health.

After a full assessment of patients and their hemorrhoidal condition, a number of issues have to be considered and discussed in order to plan a tailored strategy for each specific scenario that balances benefits and risks with adjusted patient expectations.

General concepts that need to be understood by patients and surgeons when dealing with hemorrhoids are summarized. Different criteria to assess patients’ condition and to choose surgical operation are discussed. Finally, the rationale to individualize treatment strategies for different grades of hemorrhoids is presented.

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References

  • Altomare DF, Milito G, Andreoli R et al (2008) Ligasure precise vs. conventional diathermy for Milligan-Morgan hemorrhoidectomy: a prospective, randomized, multicenter trial. Dis Colon Rectum 51:514–519

    Article  CAS  PubMed  Google Scholar 

  • Aly EH (2015) Stapled haemorrhoidopexy: is it time to move on? Ann R Coll Surg Engl 97(7):490–493

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Cavazzoni E, Bugiantella W, Graziosi L, Silvia Franceschini M, Cantarella F, Rosati E, Donini A (2013) Emergency transanal haemorrhoidal Doppler guided dearterialization for acute and persistent haemorrhoidal bleeding. Colorectal Dis 15(2):e89–e92

    Article  CAS  PubMed  Google Scholar 

  • Crosland A, Jones R (1995) Rectal bleeding: prevalence and consultation behaviour. BJM 311:486–488

    Article  CAS  Google Scholar 

  • Giordano P, Overton J, Madeddu F, Zaman S, Gravante G (2009) Transanal hemorrhoidal dearterialization: a systematic review. Dis Colon Rectum 52:1665–1671

    Article  PubMed  Google Scholar 

  • GraviĂ© FJ (2014) Correspondence: hemorrhoidal arterial ligation with mucopexy: a risk-free technique? J Visc Surg 151:421–422

    Article  PubMed  Google Scholar 

  • Grosz CR (1990) A surgical treatment of thrombosed external hemorrhoids. Dis Colon Rectum 33:249–250

    Article  CAS  PubMed  Google Scholar 

  • Hansen PL, Hjertholm P, Vedsted P (2015) Increased diagnostic activity in general practice during the year preceding colorectal cancer diagnosis. Int J Cancer 137:615–624

    Article  CAS  PubMed  Google Scholar 

  • Hardy A, Cohen CRG (2014) The acute management of haemorrhoids. Ann R Coll Surg Engl 96:508–511

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Hollingshead JRF, Phillips RKS (2016) Haemorrhoids: modern diagnosis and treatment. Postgrad Med J 92:4–8

    Article  CAS  PubMed  Google Scholar 

  • Jacobs D (2014) Hemorrhoids. N Engl J Med 371:944–951

    Article  CAS  PubMed  Google Scholar 

  • Kaidar-Person O, Person B, Wexner S (2007) Hemorrhoidal disease: a comprehensive review. J Am Coll Surg 204(1):102–117

    Article  PubMed  Google Scholar 

  • Kanellos I, Goulimaris I, Vakalis I et al (2000) Long-term evaluation of sclerotherapy for haemorrhoids. A prospective study. Int J Surg Investig 2:295–298

    PubMed  CAS  Google Scholar 

  • Lockhart-Mummery P (1925) Internal piles: diagnosis and treatment. Postgrad Med J 1:22–27

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Lohsiriwat V (2012) Hemorrhoids: from basic pathophysiology to clinical management. World J Gastroenterol 18:2009–2017

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Lohsiriwat V (2015) Treatment of hemorrhoids: a coloproctologist’s view. World J Gastroenterol 21(31):9245–9252

    Article  PubMed  PubMed Central  Google Scholar 

  • Longo A (1998) Treatment of hemorrhoidal disease by reduction of mucosa and hemorrhoidal prolapse with a circular suturing device: a new procedure. In: Monduzzi (ed) Proceedings of the 6th world congress of endoscopic surgery, Bologna, pp 777–784

    Google Scholar 

  • Madoff RD, Fleshman JW (2004) American Gastroenterological Association technical review on the diagnosis and treatment of hemorrhoids. Gastroenterology 126(5):1463–1473

    Article  PubMed  Google Scholar 

  • McCloud JM, Jameson JS, Scott AND (2006) Life-threatening sepsis following treatment for haemorrhoids: a systematic review. Color Dis 8:748–755

    Article  CAS  Google Scholar 

  • Moussa N, Sielezneff I, Sapoval M, Tradi F, del Giudice C, Fathallla N, Pellerin O, Amouyal G, Pereira H, del Paredes V, Vidal V (2017) Embolization of the superior rectal arteries for chronic bleeding due to hemorrhoidal disease. Color Dis 19(2):194–199

    Article  CAS  Google Scholar 

  • Nienhuijs SW, de Hingh IHJT (2009) Conventional versus LigaSure hemorrhoidectomy for patients with symptomatic hemorrhoids. Cochrane Database Syst Rev 1:CD006761

    Google Scholar 

  • Ratto C, Giordano P, Donisi L, Parello A, Litta F, Doglietto GB (2011) Transanal haemorrhoidal dearterialization (THD) for selected fourth-degree haemorrhoids. Tech Coloproctol 15:191–197

    Article  CAS  PubMed  Google Scholar 

  • Ratto C, Parello A, Veronese E, Cudazzo E, D’Agostino E, Pagano C, Cavazzoni E, Brugnano L, Litta F (2015) Doppler-guided transanal haemorrhoidal dearterialization for haemorrhoids: results from a multicentre trial. Color Dis 17(1):O10–O19

    Article  CAS  Google Scholar 

  • Rivadeneira DE, Steele SR, Ternent CH, Chalasani S, Buie WD, Rafferty JL, on behalf of the Standards Practice Task Force of The American Society of Colon and Rectal Surgeons (2011) Practice parameters for the management of hemorrhoids (revised 2010). Dis Colon Rectum 54:1059–1064

    Article  PubMed  Google Scholar 

  • Shanmugam V, Thaha MA, Rabindranath KS et al (2005) Rubber band ligation versus excisional haemorrhoidectomy for haemorrhoids. Cochrane Database Syst Rev 3:CD005034

    Google Scholar 

  • 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 102:1603–1618

    Article  CAS  PubMed  Google Scholar 

  • Sun Z, Migaly J (2016) Review of hemorrhoid disease: presentation and management. Clin Colon Rectal Surg 29:22–29

    Article  PubMed  PubMed Central  Google Scholar 

  • 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 19:567–575

    Article  CAS  PubMed  Google Scholar 

  • Vinson-Bonnet B, Higuero T, Faucheron JL, Senejoux A, Pigot F, Siproudhis L (2015) Haemorrhoidal surgery: systematic literature review and qualitative analysis. Int J Color Dis 30:437–445

    Article  CAS  Google Scholar 

  • Yeo D, Tan K-Y (2014) Hemorrhoidectomy – making sense of the surgical options. World J Gastroenterol 20(45):16976–16983

    Article  PubMed  PubMed Central  Google Scholar 

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Correspondence to Esther Kreisler .

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Kreisler, E., Biondo, S. (2018). Selection of Patients to the Surgical Treatment of Hemorrhoids. In: Ratto, C., Parello, A., Litta, F. (eds) Hemorrhoids. Coloproctology, vol 2. Springer, Cham. https://doi.org/10.1007/978-3-319-53357-5_8

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  • DOI: https://doi.org/10.1007/978-3-319-53357-5_8

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-53356-8

  • Online ISBN: 978-3-319-53357-5

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