The ASCRS Textbook of Colon and Rectal Surgery. Steele SR, Hull TL, Read TE, Saclarides TJ, Senagore AJ, Whitlow CB, eds. Keighley and Williams' Surgery of the Anus, Rectum & Colon. Sagar PM, Hill AG, Knowles CH, Post S, Bemelman W, Roberts PL, et al, eds. Gordon and Nivatvongs' Principles and Practice of Surgery for the Colon, Rectum, and Anus. Congestion and hypertrophy of the anal cushions ensue, making them more prone to developing edema and bleeding.īeck DE. Furthermore, straining may cause engorgement of the cushions during defecation, making their displacement more likely. Hard, bulky stools promote straining, which is more likely to push the cushions out of the anal canal. Many theories have been proposed, but the most common, and perhaps most accurate, theory pertains to the abnormal sliding of the vascular cushions that is associated with straining and irregular bowel habits. (See Technique.)ĭespite several years of study, the main etiology of hemorrhoidal disease is still largely unknown. Office-based treatments include sclerotherapy, rubber-band ligation, and infrared coagulation, Operative treatments include excisional hemorrhoidectomy, stapled hemorrhoidopexy (procedure for prolapse and hemorrhoids ), and hemorrhoid artery ligation (HAL). All patients should initially receive conservative management If this fails to improve symptoms, an office-based or operative procedure may be offered. For the most part, symptomatic hemorrhoids are a quality-of-life issue.
0 kommentar(er)
