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©2014 Baishideng Publishing Group Inc.
World J Gastroenterol. Dec 7, 2014; 20(45): 16976-16983
Published online Dec 7, 2014. doi: 10.3748/wjg.v20.i45.16976
Published online Dec 7, 2014. doi: 10.3748/wjg.v20.i45.16976
Table 1 Classification of internal hemorrhoids
Grade | Definition |
I | Normal appearance externally, bleeding but not prolapsing |
II | Anal cushions prolapse on straining but reduces spontaneously |
III | Anal cushions prolapse on straining or exertion and require manual reduction |
IV | Permanent prolapse, irreducible |
Table 2 Results for grade II hemorrhoids
Table 3 Results for grade III hemorrhoids
Methods | Mean operating time (min) | Return to work (d) | Recurrence at < 1 yr (%) | Recurrence at>1 yr (%) | Post-op bleeding (%) | ARU (%) | Fistula (%) | Anal stricture (%) |
DGHAL | 19[45] | NR | 13-13.5[9,44] | 18-31[44,45] | 0-6.8[9,45] | 1[9] | 0-0.5[9,45] | NR |
SH | 21-31[45,47-49] | 6-7.9[47,48] | 7.5[47] | 3-25.6[45,47,49,55] | 0-9.1[45,47-49] | 1.6-17.5[45,47] | 0[49] | 1.3-2.6[48,49] |
CH | 35-42.36[47-49] | 10.2-15[47,48] | 5[47] | 0-17.5[47,49,55] | 1.7-7.5[47-49] | 40[47] | 2.5[49] | 0[48,49] |
Table 4 Results for grade IV hemorrhoids
Methods | Mean operating time (min) | Return to work (d) | Recurrence at < 1 yr (%) | Recurrence at> 1 yr (%) | Post-op bleeding (%) | ARU (%) | Fistula (%) | Anal stricture (%) |
DGHAL | NR | NR | 59.3[9] | NR | 3.7[9] | 3.7[9] | 0[9] | NR |
DGHAL + RAR | 35[51] | NR | NR | 9[51] | 4[51] | NR | NR | NR |
SH | 24[52] | NR | NR | 50-53.3[52,55] | 0[52] | NR | NR | NR |
CH | 27.4-39[52,53] | 16.4[53] | NR | 0-6.25[52,53,55] | 6.25-11[52,53] | 0[53] | NR | NR |
CH + LigaSure | 22.3[53] | 12.2[53] | NR | 0[53] | 4[53] | 4[53] | NR | NR |
Table 5 Summary of recommendations
Small hemorrhoids | Large hemorrhoids | Isolated hemorrhoids | Circumferential hemorrhoids | |
Grade II | Ligation | DGHAL | Ligation | SH |
Grade III | DGHAL | CH/SH | CH | SH |
Grade IV | CH | CH | CH | CH/SH |
- Citation: Yeo D, Tan KY. Hemorrhoidectomy - making sense of the surgical options. World J Gastroenterol 2014; 20(45): 16976-16983
- URL: https://www.wjgnet.com/1007-9327/full/v20/i45/16976.htm
- DOI: https://dx.doi.org/10.3748/wjg.v20.i45.16976