Outpatient treatment of haemorrhoids by cryotherapy

Abstract

The treatment of haemorrhoids by cryosurgery is fairly new. One hundred cases have been analysed and the results presented as a preliminary report. Although the maximum follow-up is only 18 months, so far the results have been encouraging, and should they be maintained this method of outpatient haemorrhoidectomy could dramatically alter the management of this condition.

Randomized Trial of Rubber Band Ligation vs. Stapled Hemorrhoidectomy for Prolapsed Piles

“…Complications included readmission for bleeding (2), urinary retention requiring catheterization (1), and mild anal stenosis treated by outpatient digital dilation (3).…”

Rubber band ligation or lateral subcutaneous sphincterotomy for treatment of haemorrhoids

“…Although lateral subcutaneous sphincterotomy is a satisfactory means of treating patients with first-and second-degree haemorrhoids, it requires admission to a day case unit. For this reason lateral subcutaneous sphincberotomy is unlikely to be preferred to rubber band ligation in the outpatient management of piles.THE long term results of conservative therapy for firstand second-degree piles indicate that haemorrhoidectomy can usually be avoided in 90 per cent of patients (Hancock and Smith, 1975;Steinberg et al, 1975;Kaufman, 1976). During the past decade there has been an increasing tendency to use minor outpatient procedures for treatment of haemorrhoids (Leading Article, 1975).…”

Stapled Hemorrhoidectomy With Local Anesthesia can be Performed Safely and Cost-Efficiently

“…Goligher 1 recalls a patient describing a bowel movement as "like passing pieces of broken glass." For this reason, outpatient procedures such as rubber band ligation, 2-4 injection sclerotherapy, 5 infrared coagulation, 5 and cryotherapy 6 are still used frequently for Grade I and II hemorrhoids but have been shown to have high recurrence rates with Grade III and IV hemorrhoids. 5 Until the early 1990s, the two main surgical treatments for Grade III and IV hemorrhoids were open (Milligan-Morgan) 7 and closed (Ferguson) 8 techniques, which have undergone modifications over the years 9,10 but still cause patients suffering.…”