title: Clinical Outcome Following Hemorrhoid Surgery: a Narrative Review.
abstract: Surgical therapy guaranties satisfactory results, which are significantly better than those obtained with conservative therapies, especially for Grade III and IV hemorrhoids. In this review, we present and discuss the results of the most diffuse surgical techniques for hemorrhoids. Traditional surgery for hemorrhoids aims to remove the hemorrhoids, with closure (Fergusson's technique) or without closure (Milligan-Morgan procedure) of the ensuing defect. This traditional approach is effective, but causes a significant postoperative pain because of wide external wounds in the innervated perianal skin. Stapled hemorrhoidopexy, proposed by Longo, has gained a vast acceptance because of less postoperative pain and faster return to normal activities. In the recent literature, a significant incidence of recurrence after stapled hemorrhoidopexy was reported, when compared with conventional hemorrhoidectomy. Double stapler hemorrhoidopexy may be an alternative to simple stapled hemorrhoidopexy to reduce the recurrence in advanced hemorrhoidal prolapse. Transanal hemorrhoidal deartertialization was showed to be as effective as stapled hemorrhoidopexy in terms of treatment success, complications, and incidence recurrence. However, further high-quality trials are recommended to assess the efficacy and safety of this technique.
authors.affiliation: Department of Surgery, Civil Hospital "P. Colombo", Via Orti Ginnetti 7, 00049 Velletri Rome, Italy ; Via Giulio Cesare, n. 58, 04100 Latina, Italy.
authors.forename: Marcello
authors.initials: M
authors.lastname: Picchio
authors.affiliation: Department of Surgery, Civil Hospital "P. Colombo", Via Orti Ginnetti 7, 00049 Velletri Rome, Italy.
authors.forename: Ettore
authors.initials: E
authors.lastname: Greco
authors.affiliation: Department of Surgery, Sapienza University of Rome, Polo Pontino Via Firenze, s.n.c., 04019 Terracina Latina, Italy.
authors.forename: Annalisa
authors.initials: A
authors.lastname: Di Filippo
authors.affiliation: Department of Surgery, Civil Hospital "P. Colombo", Via Orti Ginnetti 7, 00049 Velletri Rome, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Marino
authors.affiliation: Department of Surgery, Hospital "S. Giovanni-Addolorata", Via dell'Amba Aradam 9, 00184 Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Stipa
authors.affiliation: Department of Surgery, Sapienza University of Rome, Polo Pontino Via Firenze, s.n.c., 04019 Terracina Latina, Italy.
authors.forename: Erasmo
authors.initials: E
authors.lastname: Spaziani
keywords: Hemorrhoids; Indication; Resection; Stapler; Surgery