Asian Journal of Surgery

Asian Journal of Surgery

Original Commodity

Analysis of Surgical Treatments for Circumferentially Protruding Haemorrhoids: Consummate Excision with Repair Using Flaps Versus Primary Excision with Secondary Suture-ligation

Background

Circumferentially protruding haemorrhoids (CPH) are troublesome lesions for both patients and surgeons, and in most cases demand surgical intervention. However, such surgery carries the risks of complications and recurrence. This report compared two surgical procedures in order to identify the optimal approach for CPH.

Methods

All patients underwent an open haemorrhoidectomy for master haemorrhoids, afterwards which patients underwent either of the 2 procedures for secondary haemorrhoids. Grouping 1 (n = 104) comprised patients who underwent submucosal excision with repair using remnant anodermal flaps; this procedure was performed between 1991 and 1996. Group two (northward = 113) comprised patients who underwent suture-ligation; this process was performed between 1997 and 2002. Surgical outcomes including surgical variables, wound healing, complications and patient satisfaction were compared between the two groups.

Results

For group ii, surgical time and duration of analgesic use (mean ± SEM, 22 ± 0 minutes and iii ± 0 days, respectively) were significantly shorter than for group one (28 ± 1 minutes and 4 ± 0 days, respectively; p < 0.001 for both comparisons). In terms of complication rates, there was no pregnant difference between group two (xv patients, xiv%) and group ane (25 patients, 22%), and most complications were satisfactorily treated using conservative management. Skin tags and perianal abscesses were more frequent in group 1 than in group 2. The final follow-upward was undertaken at 6 months postoperatively, at which time there were no recurrences in patients of either group. For both groups, over 90% of patients reported that they were satisfied with the event of surgery.

Conclusion

Although both surgical approaches were successful for treating CPH, open up haemorrhoidectomy for primary haemorrhoids combined with suture-ligation for secondary haemorrhoids appears to be the optimal approach considering its rapidity, simplicity and lower associated costs.

Key Words

circumferential

flap

haemorrhoid

surgical technique

suture

Copyright © 2006 Asian Surgical Association. Published past Elsevier B.5.