Excisional Haemorrhoidectomy: Where Are We?

Area of Science:

• Gastroenterology
• Colorectal Surgery

Background:

• Haemorrhoidal disease (HD) is a common anorectal condition characterized by symptomatic enlargement or displacement of anal cushions.
• Bright red bleeding during or after defecation is the most frequent symptom, typically appearing on the stool's surface.

Purpose of the Study:

• To review and describe common excisional surgical techniques for treating haemorrhoidal disease.
• To highlight the effectiveness of these surgical methods for advanced stages of HD.

Main Methods:

• Review of established excisional haemorrhoidectomy techniques.
• Description of Milligan and Morgan, Parks, Ferguson, and Whitehead surgical methods.

Main Results:

• Excisional haemorrhoidectomy remains the most effective treatment for Grade III and IV haemorrhoidal disease.
• While conservative treatments have improved, surgical intervention is crucial for advanced prolapse.

Conclusions:

• Surgical management, particularly excisional haemorrhoidectomy, is essential for severe symptomatic haemorrhoidal disease.
• Understanding various surgical techniques is key for effective treatment of advanced haemorrhoidal disease.