Hemorrhoids surgery: Difference between revisions

Jump to navigation Jump to search
No edit summary
m (Bot: Removing from Primary care)
 
(7 intermediate revisions by 3 users not shown)
Line 4: Line 4:


==Overview==
==Overview==
Surgery is not the first-line treatment option for patients with hemorrhoids. Surgical intervention is usually reserved for patients with either complicated or large hemorrhoids (beyond grade III)
Surgery is not the first-line treatment option for patients with hemorrhoids. Surgical intervention is usually reserved for patients with either complicated or large hemorrhoids (beyond grade III).


==Surgery==
==Surgery==
Some people require the following medical treatments for chronic or severe hemorrhoids:
Some people require the following medical treatments for [[chronic]] or severe hemorrhoids:


=== Rubber band ligation ===
=== Rubber band ligation ===
:* Rubber band ligation is sometimes called Baron ligation.  
:* [[Rubber band ligation]] is sometimes called Baron ligation.  
:* Elastic bands are applied onto an internal hemorrhoid to cut off its blood supply.<ref name="pmid16412076">{{cite journal |author=Longman RJ, Thomson WH |title=A prospective study of outcome from rubber band ligation of piles |journal=Colorectal Dis |volume=8 |issue=2 |pages=145–8 |year=2006 |pmid=16412076 |doi=10.1111/j.1463-1318.2005.00873.x}}</ref>  
:* Elastic bands are applied onto an internal hemorrhoid to cut off its blood supply.<ref name="pmid16412076">{{cite journal |author=Longman RJ, Thomson WH |title=A prospective study of outcome from rubber band ligation of piles |journal=Colorectal Dis |volume=8 |issue=2 |pages=145–8 |year=2006 |pmid=16412076 |doi=10.1111/j.1463-1318.2005.00873.x}}</ref>  
:* Within several days, the withered hemorrhoid is sloughed off during normal bowel movement.
:* Within several days, the withered hemorrhoid is sloughed off during a normal bowel movement.
{{#ev:youtube|z2hqoeS0oXA}}
{{#ev:youtube|z2hqoeS0oXA}}
{{#ev:youtube|GSKUNFqNY8w}}
{{#ev:youtube|GSKUNFqNY8w}}


=== Hemorrhoidolysis/Galvanic Electrotherapy ===
=== Hemorrhoidolysis/Galvanic Electrotherapy ===
: Hemorrhoidolysis means desiccation of the hemorrhoid by electrical current.<ref name="pmid1568400">{{cite journal |vauthors=Bleday R, Pena JP, Rothenberger DA, Goldberg SM, Buls JG |title=Symptomatic hemorrhoids: current incidence and complications of operative therapy |journal=Dis. Colon Rectum |volume=35 |issue=5 |pages=477–81 |year=1992 |pmid=1568400 |doi= |url=}}</ref>
:* [[Hemorrhoidolysis/Galvanic Electrotherapy|Hemorrhoidolysis]] means desiccation of the hemorrhoid by electrical current.<ref name="pmid1568400">{{cite journal |vauthors=Bleday R, Pena JP, Rothenberger DA, Goldberg SM, Buls JG |title=Symptomatic hemorrhoids: current incidence and complications of operative therapy |journal=Dis. Colon Rectum |volume=35 |issue=5 |pages=477–81 |year=1992 |pmid=1568400 |doi= |url=}}</ref>
;Sclerotherapy (injection therapy)
 
: The idea behind sclerotherapy is that a sclerosant or hardening agent is injected into hemorrhoids. This causes the vein walls to collapse and the hemorrhoids to shrivel up.
===Sclerotherapy (injection therapy)===
:* The idea behind [[sclerotherapy]] is that a sclerosant or hardening agent is injected into the hemorrhoids. This causes the [[vein]] walls to collapse and the hemorrhoids to shrivel up.
{{#ev:youtube|tHEboifBEfI}}
{{#ev:youtube|tHEboifBEfI}}
{{#ev:youtube|QAvKl2P0Ou0}}
{{#ev:youtube|QAvKl2P0Ou0}}


=== Cryosurgery ===
=== Cryosurgery ===
:* During cryotherapy, a frozen tip of a cryoprobe is used to destroy hemorrhoidal tissues.<ref name="pmid6979469">{{cite journal |author=MacLeod JH |title=In defense of cryotherapy for hemorrhoids. A modified method |journal=Dis. Colon Rectum |volume=25 |issue=4 |pages=332–5 |year=1982 |pmid=6979469 |doi=}}</ref>
:* During [[cryotherapy]], a frozen tip of a cryoprobe is used to destroy hemorrhoidal tissues.<ref name="pmid6979469">{{cite journal |author=MacLeod JH |title=In defense of cryotherapy for hemorrhoids. A modified method |journal=Dis. Colon Rectum |volume=25 |issue=4 |pages=332–5 |year=1982 |pmid=6979469 |doi=}}</ref>
:* Rarely used anymore because of side effects.
:* Rarely used currently because of side effects.


=== Laser, infrared or BICAP coagulation ===
=== Laser, infrared, or BICAP coagulation ===
:* [[laser]], infrared beam, or [[electricity]] is used to cauterize the affected tissues.  
:* [[Laser]], infrared beam, or [[electricity]] is used to cauterize the affected tissues.  
:* Lasers are now much less popular.  
:* Lasers are now much less popular.  
:* Infrared coagulation has been studied in comparison with RBL and found to be as effective in hemorrhoids up to grade III.   
:* Infrared coagulation has been studied in comparison with RBL and found to be as effective in hemorrhoids up to grade III.   
Line 36: Line 37:


=== Hemorrhoidectomy ===
=== Hemorrhoidectomy ===
:* Hemorrhoidectomy is a true surgical procedure to excise and remove hemorrhoids.
:* [[Hemorrhoidectomy]] is a true surgical procedure to excise and remove hemorrhoids.
:* Hemorrhoidectomy has possible correlation with incontinence issues later in life; in addition, many patients complain that pain during recovery is severe. For this reason is often now recommended only for severe (grade IV) hemorrhoids.
:* [[Hemorrhoidectomy]] has a possible correlation with incontinence issues later in life and many patients complain that pain during recovery is severe. For these reasons, it is often now recommended only for severe (grade IV) hemorrhoids.
{{#ev:youtube|fQ18G5WIo-0}}
{{#ev:youtube|fQ18G5WIo-0}}
{{#ev:youtube|iil3jeRiLrw}}
{{#ev:youtube|iil3jeRiLrw}}
=== Stapled Hemorrhoidectomy ===
=== Stapled Hemorrhoidectomy ===
:* Also called the procedure for prolapse and hemorrhoids, it is designed to resect soft tissue proximal to the dentate line, which disrupts the blood flow to the hemorrhoids.
:* Also called the procedure for [[prolapse]] and hemorrhoids, it is designed to resect soft tissue proximal to the dentate line, which disrupts the [[blood flow]] to the hemorrhoids.
:* It is generally less painful than complete removal of hemorrhoids and also allows for faster recovery times. It's meant for hemorrhoids that fall out or bleed and is not helpful for painful outside conditions.<ref name="pmid17380367">{{cite journal |vauthors=Tjandra JJ, Chan MK |title=Systematic review on the procedure for prolapse and hemorrhoids (stapled hemorrhoidopexy) |journal=Dis. Colon Rectum |volume=50 |issue=6 |pages=878–92 |year=2007 |pmid=17380367 |doi=10.1007/s10350-006-0852-3 |url=}}</ref>
:* It is generally less painful than complete removal of hemorrhoids and allows for a faster recovery time. The procedure is meant for hemorrhoids that fall out or bleed and is not helpful for painful outside conditions.<ref name="pmid17380367">{{cite journal |vauthors=Tjandra JJ, Chan MK |title=Systematic review on the procedure for prolapse and hemorrhoids (stapled hemorrhoidopexy) |journal=Dis. Colon Rectum |volume=50 |issue=6 |pages=878–92 |year=2007 |pmid=17380367 |doi=10.1007/s10350-006-0852-3 |url=}}</ref>
{{#ev:youtube|Xv2y8XtGCCY}}
{{#ev:youtube|Xv2y8XtGCCY}}
=== Doppler Guided Hemorrhoidal Artery Ligation ===
=== Doppler Guided Hemorrhoidal Artery Ligation ===
: The only evidence based surgery for all grades of hemorrhoids.  
:* The only evidence-based surgery for all grades of hemorrhoids.
: It does not involve cutting tissues or even a stay at the hospital; patients are usually back to work on the same day.  
:* It does not involve cutting tissues or even a stay at the hospital; patients are usually back to work on the same day.
: It is the best treatment for bleeding piles, as the bleeding stops immediately. <ref name="pmid16399113">{{cite journal |author=Scheyer M, Antonietti E, Rollinger G, Mall H, Arnold S |title=Doppler-guided hemorrhoidal artery ligation |journal=Am. J. Surg. |volume=191 |issue=1 |pages=89–93 |year=2006 |pmid=16399113 |doi=10.1016/j.amjsurg.2005.10.007}}</ref>
:* It is the best treatment for bleeding piles, as the bleeding stops immediately.<ref name="pmid16399113">{{cite journal |author=Scheyer M, Antonietti E, Rollinger G, Mall H, Arnold S |title=Doppler-guided hemorrhoidal artery ligation |journal=Am. J. Surg. |volume=191 |issue=1 |pages=89–93 |year=2006 |pmid=16399113 |doi=10.1016/j.amjsurg.2005.10.007}}</ref>
{{#ev:youtube|TLM_FSw_DME}}
{{#ev:youtube|TLM_FSw_DME}}
=== Recto-anal Repair  ===
=== Recto-anal Repair  ===
: Also known as mucopexy or mucosal lifting is used for managing prolapse of mucosa or hemorrhoids
:* It is also known as mucopexy or mucosal lifting. The procedure is used for managing [[prolapse]] of [[mucosa]] or hemorrhoids.
{{#ev:youtube|LcBU_Xf0C9k}}
{{#ev:youtube|LcBU_Xf0C9k}}
==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
{{WH}}
{{WS}}


[[Category:Gastroenterology]]
[[Category:Gastroenterology]]
[[Category:Surgery]]
[[Category:Surgery]]
[[Category:Primary care]]
[[Category:Needs overview]]
[[Category:Needs overview]]
{{WH}}
{{WS}}

Latest revision as of 22:04, 29 July 2020

Hemorrhoids Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Hemorrhoids from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

X Ray

CT

MRI

Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Hemorrhoids surgery On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Hemorrhoids surgery

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Hemorrhoids surgery

CDC on Hemorrhoids surgery

Hemorrhoids surgery in the news

Blogs on Hemorrhoids surgery

Directions to Hospitals Treating Hemorrhoids

Risk calculators and risk factors for Hemorrhoids surgery

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ahmed Younes M.B.B.CH [2]

Overview

Surgery is not the first-line treatment option for patients with hemorrhoids. Surgical intervention is usually reserved for patients with either complicated or large hemorrhoids (beyond grade III).

Surgery

Some people require the following medical treatments for chronic or severe hemorrhoids:

Rubber band ligation

  • Rubber band ligation is sometimes called Baron ligation.
  • Elastic bands are applied onto an internal hemorrhoid to cut off its blood supply.[1]
  • Within several days, the withered hemorrhoid is sloughed off during a normal bowel movement.

{{#ev:youtube|z2hqoeS0oXA}} {{#ev:youtube|GSKUNFqNY8w}}

Hemorrhoidolysis/Galvanic Electrotherapy

Sclerotherapy (injection therapy)

  • The idea behind sclerotherapy is that a sclerosant or hardening agent is injected into the hemorrhoids. This causes the vein walls to collapse and the hemorrhoids to shrivel up.

{{#ev:youtube|tHEboifBEfI}} {{#ev:youtube|QAvKl2P0Ou0}}

Cryosurgery

  • During cryotherapy, a frozen tip of a cryoprobe is used to destroy hemorrhoidal tissues.[3]
  • Rarely used currently because of side effects.

Laser, infrared, or BICAP coagulation

  • Laser, infrared beam, or electricity is used to cauterize the affected tissues.
  • Lasers are now much less popular.
  • Infrared coagulation has been studied in comparison with RBL and found to be as effective in hemorrhoids up to grade III.
  • These are the most readily available non-surgical procedures in the US.[4]

{{#ev:youtube|0aNTFMQrthE}} {{#ev:youtube|c-YqCJLz5-Y}}

Hemorrhoidectomy

  • Hemorrhoidectomy is a true surgical procedure to excise and remove hemorrhoids.
  • Hemorrhoidectomy has a possible correlation with incontinence issues later in life and many patients complain that pain during recovery is severe. For these reasons, it is often now recommended only for severe (grade IV) hemorrhoids.

{{#ev:youtube|fQ18G5WIo-0}} {{#ev:youtube|iil3jeRiLrw}}

Stapled Hemorrhoidectomy

  • Also called the procedure for prolapse and hemorrhoids, it is designed to resect soft tissue proximal to the dentate line, which disrupts the blood flow to the hemorrhoids.
  • It is generally less painful than complete removal of hemorrhoids and allows for a faster recovery time. The procedure is meant for hemorrhoids that fall out or bleed and is not helpful for painful outside conditions.[5]

{{#ev:youtube|Xv2y8XtGCCY}}

Doppler Guided Hemorrhoidal Artery Ligation

  • The only evidence-based surgery for all grades of hemorrhoids.
  • It does not involve cutting tissues or even a stay at the hospital; patients are usually back to work on the same day.
  • It is the best treatment for bleeding piles, as the bleeding stops immediately.[6]

{{#ev:youtube|TLM_FSw_DME}}

Recto-anal Repair

  • It is also known as mucopexy or mucosal lifting. The procedure is used for managing prolapse of mucosa or hemorrhoids.

{{#ev:youtube|LcBU_Xf0C9k}}

References

  1. Longman RJ, Thomson WH (2006). "A prospective study of outcome from rubber band ligation of piles". Colorectal Dis. 8 (2): 145–8. doi:10.1111/j.1463-1318.2005.00873.x. PMID 16412076.
  2. Bleday R, Pena JP, Rothenberger DA, Goldberg SM, Buls JG (1992). "Symptomatic hemorrhoids: current incidence and complications of operative therapy". Dis. Colon Rectum. 35 (5): 477–81. PMID 1568400.
  3. MacLeod JH (1982). "In defense of cryotherapy for hemorrhoids. A modified method". Dis. Colon Rectum. 25 (4): 332–5. PMID 6979469.
  4. Greenspon J, Williams SB, Young HA, Orkin BA (2004). "Thrombosed external hemorrhoids: outcome after conservative or surgical management". Dis. Colon Rectum. 47 (9): 1493–8. doi:10.1007/s10350-004-0607-y. PMID 15486746.
  5. Tjandra JJ, Chan MK (2007). "Systematic review on the procedure for prolapse and hemorrhoids (stapled hemorrhoidopexy)". Dis. Colon Rectum. 50 (6): 878–92. doi:10.1007/s10350-006-0852-3. PMID 17380367.
  6. Scheyer M, Antonietti E, Rollinger G, Mall H, Arnold S (2006). "Doppler-guided hemorrhoidal artery ligation". Am. J. Surg. 191 (1): 89–93. doi:10.1016/j.amjsurg.2005.10.007. PMID 16399113.

Template:WH Template:WS