Symposium I: Treatments of the Hemorrhoids

Abstract

On the treatment of hemorrhoids, conserative procedure is basically preferable. Longstanding prolapsed internal hemorrhoids, however, should be treated surgically because the condition of its vessel wall has irreversibly changed.
For thrombosed prolapsed inrernal hemorrhoids, surgical treatment is preferable a few days later when the acute sign and symptom have decreased. Although most of them are treated conservatively at our hospital, we have not encountered the recurrences.
On the surgical treatment, circumferential removal of hemorrhoidal zone such as Whitehead's operation should not be recommended because of not only its anatomical and physical unreasonableness but also its several postoperative anal disturbances.
Concerning the surgical operation for hemorrhoids, we might say "too much is worse than too little" than "too much is as bad as too little".
Most important thing is the preservation of anal function. "Ligation and excision procedure" is removal of main three or four hemorrhoids with ligation of roots of their hemorrhoidal arteries along the longitudinal axis of the anal canal. This method is, simple and most of hemorrhoids are completely cured without any post-operative anal disturbance.