Non-resectional procedures as treatment options for Hemorrhoidal disease.

Abstract

Hemorrhoids have been recorded through hundreds of years of history. It is a very common condition affecting millions of people around the world every year with an estimated prevalence of 4.4% of the population in the United States. Hemorrhoids are defined as the pathological enlargement and downward displacement of the anal cushions. The risk factors of this condition include a low-fiber diet, constipation, and prolonged straining. It is clinically manifested by painless bleeding with the bowel movement with or without prolapse. Other symptoms like pain or pruritus that affect the patients’ quality of life. Hemorrhoids can be managed by multiple surgical and non-surgical treatments. Excisional hemorrhoidectomy is still considered the “gold standard” for the treatment of high-grade and complicated hemorrhoids, but significant postoperative pain and limitations of daily activities remain the major obstacles of this procedure. Currently, the treatment strategy for hemorrhoidal disease has changed from “resection and radical treatment” to the elimination or relief of symptoms. This has led surgeons to adopt more tolerable and minimally invasive techniques, such as rubber band ligation, injection sclerotherapy, infrared coagulation, laser hemorrhoidoplasty, hemorrhoidal artery ligation, and stapled hemorrhoidopexy. However, no particular technique has been widely considered as a single best treatment.