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World J Surg Proced. Nov 28, 2014; 4(3): 55-65
Published online Nov 28, 2014. doi: 10.5412/wjsp.v4.i3.55
Recent advances in the management of hemorrhoids
Mahmoud Sakr, Khaled Saed
Mahmoud Sakr, Khaled Saed, Department of Surgery, Faculty of Medicine, University of Alexandria, Alexandria 21500, Egypt
Author contributions: Both of the authors solely contributed to this paper.
Correspondence to: Mahmoud Sakr, MD, PhD, FACS, Professor of Surgery, Faculty of Medicine, University of Alexandria, Champillion St., Azarita, Alexandria 21500, Egypt.
Telephone: +2-3-5899420 Fax: +2-3-4841189
Received: March 20, 2014
Revised: September 16, 2014
Accepted: October 28, 2014
Published online: November 28, 2014
Core Tip

Core tip: Patients with Grades I-II hemorrhoids can be treated with medical treatment or office procedures. For Grades III-IV, surgical treatment should be offered and individually tailored to each patient. Conventional hemorrhoidectomy is the gold-standard, albeit with severe post-operative pain. LigaSure and harmonic scalpel hemorrhoidectomy offer shorter operative time, less post-operative pain and less time off work. Stapled hemorrhoidopexy provides similar results. However, though rare, devastating complications may occur, and so, should be performed only by experienced surgeons. Hemorrhoidal artery ligation is a potential non-excisional technique for the treatment of Grades II-III hemorrhoids with minimal postoperative pain and quick recovery.