Cryosurgery for life-threatening bleeding hemorrhoids in the elderly

Forty-three elderly patients with massive bleeding of hemorrhoidal varices were treated by cryosurgery at a single outpatient session, using nitrous oxide gas, without premedication or anesthesia. The results were excellent in all but one patient, who had ulcerative colitis and required another session of cryotherapy following a recurrence of bleeding. There was no morbidity and no mortality. The patients have remained free of symptoms over follow-up periods ranging from two to five years. The authors believe that cryosurgery is the treatment of choice and indeed may sometimes be life-saving for elderly, poor-risk patients who are unfit for general anesthesia and surgical hemorrhoidectomy.