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Circular hemorrhoidectomy in advanced hemorrhoidal disease
P Boccasanta1, M Venturi, A Orio
1Istituto di Chirurgia Generale e di Oncologia Chirurgica dell'Universita di Milano, Ospedale Policlinico IRCCS, Milan, Italy.
Hepato-Gastroenterology
|October 2, 1998
Summary
The Hopital Leopold Bellan (HLB) hemorrhoidectomy offers a low 4% recurrence rate for advanced circular hemorrhoids. While complications are higher than traditional methods, they are manageable without increasing hospital stay.
Area of Science:
- Colorectal Surgery
- Surgical Techniques
- Hemorrhoidal Disease Management
Background:
- Milligan-Morgan hemorrhoidectomy shows high recurrence rates (>10%) for circular IV grade hemorrhoids.
- Advanced hemorrhoidal disease necessitates alternative surgical approaches.
- Circular hemorrhoidectomy with complete pile elimination and anoplasty may improve outcomes.
Purpose of the Study:
- To evaluate the efficacy of the Hopital Leopold Bellan (HLB) technique for advanced hemorrhoidal disease.
- To compare HLB technique outcomes with other reported hemorrhoidectomy methods.
- To assess recurrence and complication rates of the HLB technique in a retrospective study.
Main Methods:
- Retrospective analysis of 100 consecutive patients with circular IV grade hemorrhoids.
- Patients underwent radical hemorrhoidectomy using the HLB technique between January 1987 and December 1996.
- Postoperative care included strict monitoring and anal dilators for fibrosis; mean hospital stay was 4 days.
Main Results:
- Complete recovery reported in 81% of patients.
- Recurrence rate significantly reduced to 4% compared to traditional methods.
- Cumulative complication rate was 34%, with increased early/late hemorrhages but similar anal stenosis incidence.
Conclusions:
- The HLB operation is a highly effective choice for advanced circular hemorrhoids due to its radical approach and favorable results.
- Postoperative morbidity associated with HLB hemorrhoidectomy is higher but complications are manageable.
- The HLB technique demonstrates successful outcomes in treating complex hemorrhoidal disease.