[Hemorrhoids. Medico-surgical treatment]

The clinical history of 300 patients examined by the author at San Fernando Clinic and 90 consecutive cases operated at CHMCSS were studied. The frequency and characteristics of symptoms, the gender prevalence, the physical findings, the clinical classification and the various therapeutic methods used were determined. It was noticed that 84% of the patients received conservative treatment and 16% were subjected to surgery. The conservative treatment consisted of high fiber diets, warm sits baths, psyllium, hemorrhoidal sclerosis or ligature with rubber bands. The surgical treatment consisted of the ligature and excision of the three primary hemorrhoids and of the hemorrhoidal plexus(5), which is a simple, fast and effective technique, because the removal of the hemorrhoidal cushion avoids recurrences. Furthermore, the suturing of the longitudinal fibers and the pedicle and their fixation to the external sphincter avoids the upward retraction of the pedicle and the formation of denuded areas in the anal canal that can lead to stenosis at the level of the anorectal ring.