Abstract
Backgrounds : For prolapsing internal hemorrhoids, less invasive treatments such as sclerotherapy using aluminum potassium sulphate/tannic acid (ALTA), and procedure for prolapse and hemorrhoids (PPH) have been introduced recently. We compared the results of ALTA and PPH with those of conventional hemorrhoidectomy. Methods : Between January 2006 and December 2007, we performed conventional hemorrhoidectomy in 331 patients, ALTA in 565 patients, and PPH in 73 patients. Results : Durations of hospital stay were 6.8±2.0 (mean±SD) days in the hemorrhoidectomy group, and 4.2±1.5 days in the PPH group. ALTA could be performed on an outpatient basis without any severe complications. The mean volume of ALTA injected into hemorrhoids was 7.1±2.1mL. The disappearance rates of prolapse were 100% in the hemorrohidectomy, 96.1% in the ALTA, and 98.6% in the PPH group. Conclusions : Conventional hemorrhoidectomy can be indicated for alomost all cases of prolapsing internal hemorrhoids. However, it needs hospitalization, being accompanied with post-operative pain. ALTA is feasible on an outpatient basis without any severe post-operative pain or complications. PPH is a useful alternative treatment be cause it permits of shorter duration of hospital stay and less pain than the conventional hemorrhoidectomy. Less invasive treatments appear to be useful, if we carefully choose candidates for the treatments and pay attention to avoid complications.
