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J Comp Eff Res 2021 Apr 30. Epub 2021 Apr 30.

State Scientific Center of Coloproctology, Ministry of Health of Russian Federation, Moscow, Russia.

Hemorrhoidal disease (HD) is common in adults. Treatment is largely conservative, although more invasive procedures may be required. Venoactive drugs such as micronized purified flavonoid fraction (MPFF) are widely used, but a recent and comprehensive review of supporting evidence is lacking. Read More

Surg Innov 2021 Apr 8:15533506211007292. Epub 2021 Apr 8.

Division of General, Mini-invasive and Obesity Surgery, University of Study of Campania "Luigi Vanvitelli", Naples, Italy.

Purpose: Hemorrhoidal disease (HD) is a widespread condition severely influencing patients' quality of life. Recently, the large diffusion of stapled hemorrhoidopexy has revealed a new unexpected pathological entity: the asymmetric mucosal prolapse. We aimed to assess the outcomes of the sectorial longitudinal augmented prolapsectomy (SLAP), a technique dedicated to asymmetric prolapse, in terms of HD symptoms, prolapse recurrence, and rectal stenosis. Read More

J Ayub Med Coll Abbottabad 2021 Jan-Mar;33(1):125-128

Department of Surgery, Dow University OF Health Sciences, Karachi, Pakistan.

Background: Hemorrhoids are one of the most common anal pathology affecting millions of people around the world. Milligan-Morgan open hemorrhoidectomy is the most effective hemorrhoidectomy method used as gold standard procedure. Post-operative pain is recognized as a distressing complication of hemorrhoidectomy leading to increase hospital stay and psychological stress to both patient and surgeon. Read More

Acta Gastroenterol Belg 2021 Jan-Mar;84(1):101-120

Department of Gastroenterology and Hepatology, University Hospital Ghent, Ghent, Belgium.

Introduction: Hemorrhoidal disease is a common problem that arises when hemorrhoidal structures become engorged and/or prolapse through the anal canal. Both conservative and invasive treatment options are diverse and guidance to their implementation is lacking.

Methods: A Delphi consensus process was used to review current literature and draft relevant statements. Read More

Chirurgia (Bucur) 2021 Jan-Feb;116(1):102-108

Stapled hemorrhoidopexy (Longo operation) is a infrequent technique in our area. A different concept from hemorrhoidectomy, a proportionally important raise in cost and a special training may have contributed to it. We report our long-term results with the standard technique. Read More

Ann Palliat Med 2021 Jan;10(1):479-483

Department of Anorectal Surgery, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China. Email:

Background: Post-hemorrhoidectomy pain is common, usually temporary, and responsive to analgesics. However, some patients experience prolonged, intractable anal pain, which is refractory to conventional analgesics and adversely effects quality of life. We aimed to evaluate the efficacy of a combination injection containing local anesthesia and steroids for the treatment of intractable post-hemorrhoidectomy anal pain. Read More

World J Clin Cases 2021 Jan;9(1):36-46

Department of Anorectal Surgery, The 2 Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China.

Background: Hemorrhoidal prolapse is a common benign disease with a high incidence. The treatment procedure for prolapse and hemorrhoids (PPH) remains an operative method used for internal hemorrhoid prolapse. Although it is related to less pos-operative pain, faster recovery and shorter hospital stays, the postoperative recurrence rate is higher than that of the Milligan-Morgan hemorrhoidectomy (MMH). Read More

World J Gastrointest Oncol 2021 Jan;13(1):87-91

Department of Surgery, The Jewish Hospital, Cincinnati, OH 45236, United States.

Background: The incidence of carcinoma found within an internal hemorrhoid specimen is exceptionally rare. Further, the presence of primary anal canal adenocarcinoma within internal hemorrhoids is even more infrequent. We describe a case in which anal canal adenocarcinoma was found within an internal hemorrhoidectomy specimen and perform a review of the current literature. Read More

World J Surg Oncol 2021 Jan 13;19(1):14. Epub 2021 Jan 13.

Department of Gastrointestinal Surgery, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi, 470-1192, Japan.

Background: Colorectal anastomosis using the double stapling technique (DST) has become a standard procedure. However, DST is difficult to perform in patients with anal stenosis because a circular stapler cannot be inserted into the rectum through the anus. Thus, an alternative procedure is required for colorectal anastomosis. Read More

Minerva Chir 2021 Jan 12. Epub 2021 Jan 12.

Department of Anorectal Surgery, Shuguang Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai, China -

Bachground: To evaluate the clinical efficacy of suture-fixation mucopexy in the treatment of prolapsed hemorrhoids.

Methods: A total of 123 patients with grade II, III, and IV hemorrhoids were admitted to The TCM Hospital of Pu Dong New District between 2018 and 2019. They were randomly divided into the suture-fixation group (SF, n=60) and the Milligan-Morgan hemorrhoidectomy group (MM, n=63). Read More

Zhonghua Wei Chang Wai Ke Za Zhi 2020 Dec;23(12):1194-1199

Department of Colorectal and Anal Surgery, the Sixth Affiliated Hospital, Sun Yet-sen University, Guangzhou, Guangdong 510655, China.

Currently, various treatments such as hemorrhoidectomy, ligation and sclerotherapy injection can be applied in grade II or III hemorrhoids. This study aims to compare the clinical efficacy, safety and economy between Shaobei injection and elastic band ligation in treating patients with grade II or grade III hemorrhoids. A retrospective cohort study was used. Read More

Zhonghua Wei Chang Wai Ke Za Zhi 2020 Dec;23(12):1135-1138

Prolapsed hemorrhoids is a common clinical disease, and severe symptoms can significantly affect work and life. The transanal stapler has the advantages of simple operation and less trauma in treating prolapsed hemorrhoids. Its clinical efficacy is closely related to the selection of indications, the standardization of surgical operations, and the prevention and treatment of complications. Read More

Surg Technol Int 2020 Nov;37:109-112

Section of Colorectal Surgery, Department of Surgery, Westchester Medical Center, New York Medical College, Valhalla, NY.

Introduction: Current evidence suggests that transanal hemorrhoidal dearterialization (THD) is associated with less postoperative pain and faster recovery than Ferguson hemorrhoidectomy. However, there is some uncertainty regarding the durability of the therapeutic effect in terms of recurrent disease. Objective and significance: The aim of this study will be to evaluate the outcome of THD compared to Ferguson hemorrhoidectomy in terms of recurrence rate at 1-year follow-up. Read More

Medicine (Baltimore) 2020 Nov;99(45):e23122

Department of Anorectal Surgery, Changshu Hospital Affiliated to Nanjing University of Chinese Medicine, Changshu, Jiangsu Province.

Introduction: Hemorrhoidal disease is one of the most common and frequently occurring benign anorectal disorders, presented with bleeding and prolapsed, and surgery is the main and effective method for severe prolapsed hemorrhoids. Yet, the recurrence rate after procedure for prolapse and hemorrhoids (PPH) is significantly higher. To reduce the recurrence rate and protect the anus function, we try to carry out a randomized, controlled, prospective study to compare the efficacy and recurrence rate of tissue selecting technique (TST) with mega-window stapler (TST-MS) combined with anal canal epithelial preservation operation and PPH combined with external hemorrhoidectomy and inferior internal hemorrhoid ligation operation for the treatment of severe prolapsed hemorrhoids. Read More

Rev Recent Clin Trials 2021 ;16(1):101-108

General Surgery, Department of Surgical Science, Tor Vergata University, Rome,, Italy.

Background: Hemorrhoidal disease represents one of the most common anorectal disorders in the general population. Energy devices, such as LigaSure scalpel, have reshaped the concept of hemorrhoid surgery and in turn, have improved patient outcomes and simplified the work of surgeon.

Objective: The study aims to evaluate the outcomes of LigaSure hemorrhoidectomy (LH) analyzing main post-operative complications rate, length of stay, operating time, and time to return to work. Read More

Surgery 2021 03 29;169(3):610-616. Epub 2020 Sep 29.

Price Institute of Surgical Research, Department of Surgery, University of Louisville School of Medicine, Louisville, KY. Electronic address:

Background: Anal squamous cell carcinoma incidence is increasing nationally and, more so, in Kentucky. Squamous cell carcinoma of the anus unexpectedly identified at hemorrhoidectomy pathologic evaluation is not uncommon. We hypothesized this is occurring more frequently and sought to evaluate its impact on outcomes. Read More

Arq Bras Cir Dig 2020 24;33(2):e1504. Epub 2020 Aug 24.

Department of Gastroenterology, Faculty of Medicine, University of São Paulo, SP, Brazil.

Background: Transanal haemorrhoidal dearterialization with mucopexy (THD-M) is a valuable option for treating patients with haemorrhoidal disease. However, there is still controversy with regard to its efficacy for more advanced grades.

Aim: To evaluate the effectiveness of THD-M technique for treating hemorrhoidal disease and to compare the immediate and late results in different grades. Read More

J Surg Res 2020 11 11;255:632-640. Epub 2020 Jul 11.

Case Western Reserve University School of Medicine, Cleveland, OH; University Hospitals Cleveland Medical Center/UH-RISES: Research in Surgical Outcomes & Effectiveness Center), Cleveland, OH. Electronic address:

Background: Anorectal procedures are frequently performed and have the potential to be particularly painful. There are no evidence-based guidelines regarding opioid prescribing after anorectal surgery and limited data on how surgeons determine opioid prescriptions after anorectal procedures. We hypothesize significant variations in prescribing practices. Read More

Sci Rep 2020 05 14;10(1):8009. Epub 2020 May 14.

Department of General Surgery and Specialties "Paride Stefanini", Sapienza University of Rome, Rome, 00161, Italy.

Phlebotonics' effects were evaluated to reduce time-to-stop bleeding and anal irritation in 130 patients who complained of hemorrhoidal disease (HD); bleeding and pain after hemorrhoidectomy (31 patients) and hemorrhoidal thrombosis (34 patients) in the short time. Sixty patients were randomized to receive the routine treatment (both conservative and surgical) (control Group C). The treated group (both conservative and surgical) was divided into two subgroups: one treated with flavonoids (Group A, n = 73), the other with Centella (Group B, n = 66). Read More

Adv Ther 2020 06 12;37(6):2792-2812. Epub 2020 May 12.

State Scientific Center of Coloproctology, Ministry of Health of Russian Federation, Moscow, Russia.

Introduction: Hemorrhoidal disease (HD) is a common and recurrent problem for many adults worldwide. Venoactive drugs, such as micronized purified flavonoid fraction (MPFF; Daflon), have been used to treat HD and their clinical benefits have been demonstrated in previous meta-analyses of clinical trials. The aim of this study was to evaluate the efficacy of MPFF across the broader spectrum of signs and symptoms following treatment of patients with HD. Read More

Khirurgiia (Mosk) 2020 (3):89-96

A.N. Ryzhikh State Scientific Center of Coloproctology of the Ministry of Health of Russia, Moscow, Russia.

Objective: To analyze efficacy and safety of submucosal laser ablation of internal hemorrhoids (SLT).

Material And Methods: Systematic review included 10 articles published in electronic databases PubMed, Cochrane Library, Elibrary until January 2019. There were only full-text publications from prospective clinical trials devoted to submucosal laser ablation in the treatment of hemorrhoids. Read More

Sci Rep 2020 03 23;10(1):5189. Epub 2020 Mar 23.

Division of colorectal surgery, Department of surgery, Taipei Medical University Shuang-Ho Hospital, Taipei City, Taiwan.

Stapled hemorrhoidopexy has a few advantages such as less postoperative pain and faster recovery compared with conventional hemorrhoidectomy. There are two major devices used for stapled hemorrhoidopexy, PPH stapler (Ethicon EndoSurgery) and DST stapler (Covidien). This study was conducted to investigate the postoperative outcomes among patients with grade III and IV hemorrhoids who underwent hemorrhoidopexy with either of these two devices. Read More

Rev Recent Clin Trials 2021 ;16(1):32-38

Department of Colorectal Surgery, Pole des Maladies de l'Appareil Digestif (PMAD), Beaujon Hospital, Assistance Publique-Hopitaux de Paris (AP-HP), University Denis Diderot (Paris VII), 100 Boulevard du General Leclerc, 92110, Clichy, France.

Anal post-operative pain is one of the principal issues of surgical treatment of hemorrhoids and remains a distressing problem, for patients and physicians. Recent studies have concluded that appropriate postoperative pain management leads to higher patient satisfaction, earlier mobilization, fewer drug complications, eliminated adverse events, faster recovery, and decreased health care cost. However, despite advances in pain medicine, postoperative pain control remains problematic and remains an important unresolved issue that causes expense and patient dissatisfaction. Read More

Surg Innov 2020 Jun 5;27(3):272-278. Epub 2020 Mar 5.

Sapienza University of Rome, Rome, Italy.

Recently, the use of radiofrequency for hemorrhoidectomy has minimized incidence of postoperative complications. Effectiveness of LigaSure is demonstrated, but it is quite expensive. This study aims to compare LigaSure with Caiman, a cheaper instrument that uses radiofrequency for hemorrhoidectomy. Read More

Khirurgiia (Mosk) 2020 (2):39-47

Sechenov First Moscow State Medical University of the Ministry of Health of Russia, Moscow, Russia.

Objective: To study the factors influencing the physicians' choice of treatment strategy in patients with acute perianal thrombosis.

Material And Methods: A survey was conducted among 124 Russian colorectal surgeons.

Results: This survey showed that the choice of treatment strategy varies between private and state clinics. Read More

Adv Ther 2020 03 29;37(3):1136-1144. Epub 2020 Jan 29.

OnCare Medical Technology Company Limited, Hanoi, Vietnam.

Introduction: Doppler-guided transanal hemorrhoidal dearterialization (THD) was considered a less invasive and innovative method to treat hemorrhoidal disease, but it may impact the anal area during dearterialization and mucopexy. Thus, this study aimed to assess any changes in anorectal manometry of grade III and IV hemorrhoidal patients following THD treatment.

Methods: This prospective observational study was conducted with patients who had grades III and IV hemorrhoidal disease. Read More

Tech Coloproctol 2020 02 28;24(2):199-205. Epub 2020 Jan 28.

S. Spirito Hospital, Bra, Italy.

Background: The hemorrhoid laser procedure with suture-pexy (HeLPexx), consisting of Doppler-guided hemorrhoidal dearterialization with laser and the addition of anal mucopexy, is a novel non-excisional procedure to treat hemorrhoids. The aim of the present study was to describe the technique and report the clinical and long-term results.

Methods: A prospective study was conducted on patients with grade III hemorrhoids who had HeLPexx from January 2012 to February 2018. Read More

Tech Coloproctol 2020 03 14;24(3):261-262. Epub 2020 Jan 14.

Department of General Surgery, İzmir Katip Çelebi University Atatürk Training and Research Hospital, Izmir, Turkey.

Anal stenosis (AS), which is a very rare but serious complication, usually develops after hemorrhoidectomy. It may be mild, moderate or severe depending on the grade of stenosis. While mild and moderate types can be monitored with conservative treatment, most of the severe type require advancement flap anoplasty. Read More

Clin Imaging 2020 Apr 28;60(2):216-221. Epub 2019 Dec 28.

Department of Diagnostic Imaging, Chaim Sheba Medical Center, Ramat Gan, Israel; Sackler School of Medicine, Tel-Aviv University, Israel. Electronic address:

Introduction: We aimed to describe computed tomography (CT) findings of early complications after interventional hemorrhoid treatments in emergency department (ED) patients.

Materials And Methods: We identified all ED patients requiring abdominal and/or pelvic CT between February 2012 and February 2019, and included only patients who underwent CT for suspected early (up to 30 days) post hemorrhoidectomy procedure complications. Presenting symptoms, salient CT findings and clinical outcomes were collected. Read More

Int J Surg 2020 Feb 27;74:53-60. Epub 2019 Dec 27.

People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, 350003, China. Electronic address:

Background: Hemorrhoids are one of the most common conditions in the world, and grade III and IV internal hemorrhoids are mainly treated with surgery. However, there are many different surgical methods, and many postoperative complications occur. Therefore, we aimed to update and expand our previous work to compare the safety and efficacy of the procedure for prolapse and hemorrhoids (PPH), Milligan-Morgan hemorrhoidectomy (MMH) and tissue-selecting therapy stapler (TST) in the treatment of grade III and IV internal hemorrhoids. Read More