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Holzheimer RG, Mannick JA, editors. Surgical Treatment: Evidence-Based and Problem-Oriented. Munich: Zuckschwerdt; 2001.

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Surgical Treatment: Evidence-Based and Problem-Oriented.

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Surgical Treatment of Haemorrhoids

. Medical Faculty, Martin Luther University, Halle-Wittenberg, Germany

Haemorrhoids are common in men and women. About half of the population has haemorrhoids by the age of 50. It has been estimated that 58% of people over 40 years have haemorrhoids in the United States (1).


In general, there are two types of haemorrhoids: internal and external haemorrhoids. Internal haemorrhoids are classified as:

Image ch39tu1.jpg

There is no similar classification for external haemorrhoids. They are considered to be swelling of the skin and anoderm around the anus. Skin tags are later stages of external haemorrhoids (2).


Haemorrhoids are swollen blood vessels in and around the anus and lower rectum that stretch under pressure. Increased pressure and swelling may result from straining to move the bowel. Other contributing factors included pregnancy, heredity, aging, and chronic constipation or diarrhea (25).


The following physical signs may accompany haemorrhoids: bleeding, prolapse, pain, itching, rectal dysfunction, soiling.

Differential diagnosis

Differential diagnosis of haemorrhoids includes anal tags, fibrous anal polyp, anal fissure, dermatitis, perianal haematoma, rectal prolapse, and rectal tumor (6).

Treatment options for haemorrhoids include

  • Rubber band ligation
  • Infrared photocoagulation
  • Bipolar diathermy
  • Sclerotherapy
  • Cryotherapy
  • Open Haemorrhoidectomy
  • Closed haemorrhoidectomy
  • Anal dilation
  • Pile stitching
  • Stapled haemorrhoidectomy

Treatment modalities for haemorrhoids

A more conservative approach is the first line treatment for haemorrhoids in most instances. There are several treatment options available: Rubber band ligation (RBL), infrared coagulation (IRC), sclerotherapy, anal dilatation, bipolar coagulation, and direct current coagulation. Most studies have investigated the effect of rubber band ligation. Single versus multiple rubber band ligation was investigated in two randomized studies (7, 8). There was no difference in rebanding rate, complications, discomfort or pain. However, triple RBL was more cost-effective.

In comparison to sclerotherapy, RBL may cause more treatment discomfort, but RBL is considered the best treatment for 2° haemorrhoids (911). Photo- or Infrared-Coagulation may have less side effects (bleeding, pain) than RBL. Patients were often more satisfied with the treatment success of RBL (1214). Recurrence of prolapse was more often observed after IRC treatment (15). When comparing sclerotherapy with photocoagulation both therapy modalities were considered equivalent; however, after photocoagulation repeated therapy was necessary (16). Current coagulation and bipolar coagulation did not demonstrate any improvement when compared to other treatment modalities (17, 18). A recent study has investigated the use of Kamillosan ointment RBL plus anal dilation plus vaseline and showed superiority to RBL alone and RBL plus anal dilatation (19). A comparison of RBL with anal dilation has not detected a difference in outcome (20). In a recent meta-analysis of hemorrhoidal treatments it was concluded that Rubber band ligation is the initial mode of therapy for 1° to 3° haemorrhoids (21). (Table I)

Table I. Randomized studies comparing rubber band ligation, sclerotherapy, and photocoagulation.

Table I

Randomized studies comparing rubber band ligation, sclerotherapy, and photocoagulation.

Operative haemorrhoidectomy techniques have been compared in randomized studies since 1979. Anal dilation may reduce anal pressure significantly. However, in most studies anal dilation gave either poor results or anal dilation was associated with faecal incontinence (2226). The results after sphincterotomy are controversial. Sphincterotomy has been used as additional therapy in two randomized studies with good results; however, in a recent study there were more cases of anal incontinence reported after sphincterotomy (2529). Submucosal haemorrhoidectomy produced as similar outcome when compared to ligation/excision haemorrhoidectomy (30). Although there was no difference in pain diathermy excision without ligation was associated with less postoperative analgesic requirement compared to conventional scissors excision/ligation (31). Milligan-Morgan (MM) operation and diathermy had less pain and a faster canalization than closed haemorrhoidectomy (Ferguson). There was no difference in postoperative haemorrhage after MM and diathermy (32). Closed haemorrhoidectomy did not differ in pain, analgesic requirements, and length of hospital stay, from open haemorrhoidectomy; however, complete wound healing took longer after closed haemorrhoidectomy (33). Diathermy closed haemorrhoidectomy was associated with less postoperative analgesic requirement than scissors closed haemorrhoidectomy (34). In day case surgery there was no difference at all between open and closed haemorrhoidectomy (35). Two studies described less pain, faster return to normal activity, less hospital stay after stapled haemorrhoidectomy. However, there are serious concerns raised about the follow-up of patients treated by stapled haemorrhoidectomy. Persistent pain in one study lead to the dissolution of the study (3638). Studies on laser therapy, cryosurgery, bipolar or direct current coagulation did not demonstrate evidence enough to recommend these techniques in general. They may be useful in special situations. (Table II)

Table II. Randomized studies comparing open and closed haemorrhoidectomy, diathermy, anal dilation, and sphincterotomy.

Table II

Randomized studies comparing open and closed haemorrhoidectomy, diathermy, anal dilation, and sphincterotomy.

In summary, rubber band ligation is the treatment of choice for 1° to 3° haemorrhoids. Other treatment modalities may be used as adjunct therapy. In case rubber band ligation is not successful or 3° to 4° haemorrhoids operative haemorrhoidectomy is indicated. Open or closed haemorrhoidectomy show similar results. Diathermy excision of haemorrhoids seems to have the advantage of less analgesic requirement and faster procedure time. It is too early to announce a recommendation for stapled haemorrhoidectomy, although there are two randomized studies with promising results. However, the follow up of these studies is too short and there are alarming reports on pain and complications with regard to the use of stapled haemorrhoidectomy (39) (Grade A-C).

Additional treatment for haemorrhoids

Haemorrhoid treatment, especially haemorrhoidectomy or RBL, is associated with treatment discomfort. Several randomized studies were performed to reduce the pain and analgesic requirement after haemorrhoid treatment. Lactulose given four days preoperatively (40) and high fiber diet (41) may effectively reduce pain. Special dressings may help to reduce pain at the time of removal of rectal packing (42). Locally injected bupivacaine had no effect on pain or analgesic requirement after haemorrhoidectomy (43). The effect on pain after RBL is only short-term (44). Wound infiltration with lignocaine prolongs the postoperative analgesia after haemorrhoidectomy with spinal anaesthesia (45). Topical applied anaesthesia followed by local anesthetic injection, however, may be as effective as general anaesthesia (46). Transdermal fentanyl injection reduces the postoperative requirement of narcotics and may thereby improve the transition to outpatient management (47). A local ischiorectal fossa block decreased postoperative pain after haemorrhoidectomy (48). Similar results were achieved, when a transcutaneous electrical nerve stimulation was applied after haemorrhoidectomy; however, further studies need to confirm this result and the clinical feasibility (49). Ketorolac has been investigated in pain control after haemorrhoidectomy and anorectal surgery (50, 51). Pain and analgesic requirements were significantly reduced, patients were more satisfied and there was no urinary retention observed. A comparison of 2% lignocaine, 0.5% bupivacaine, 2% lignocaine + morphine sulfate, morphine sulfate and no injection demonstrated that postoperative analgesic requirement was best reduced by morphine and morphine + lignocaine resulting in a longer analgesic period. However, the number of patients requiring postoperative opiates was not affected by any treatment modality (52). Other analgesic compounds investigated were nimesilide versus naproxen; both drugs were equally effective in reducing pain and edema after haemorrhoidectomy (53). An effective pain treatment may be the addition of metronidazole three times daily for seven days (54). Anal sphincter relaxation by trimebutine was not effective in reducing postoperative pain (55), despite a 35% reduction in anal pressure. The use of cortisone has reduced postoperative pain, but only during the first 24 hours (56).

Urinary retention is a possible complication of haemorrhoidectomy. It has been suggested that patient's anxiety may induce urinary retention. However, anxiolytic treatment (midazolam) had no effect on urinary retention (57).

Bleeding, another complication after haemorrhoid treatment may be influenced by high fibre diet (58) or micronized flavonoids (59, 60). Dressing does not influence postoperative haemorrhage (42).

In summary, there is evidence that pretreatment with metronidazole, lactulose and high-fibre diet may help to overcome some of the side effects of haemorrhoid operations. Local injection of anaesthetics may prolong the analgesic time postoperatively.

In conclusion, randomized studies in haemorrhoid treatment have been performed already more than 20 years ago, adding evidence to haemorrhoid treatment. Unfortunately many studies do not classify the haemorrhoids treated. Follow-up often is short and the number of studied patients small. Nevertheless, haemorrhoid treatment appears to be based on firm evidence when compared to other surgical diseases.


Cohen Z. Alternatives to surgical haemorrhoidectomy. Can J Surg. 1985;28:230–231. [PubMed: 2986805]
Dennison A R, Wherry D C, Morris D L. Hemorrhoids. Nonoperative management. Surg Clin North Am. 1988;68:1401–1409. [PubMed: 3057666]
Burkitt D P, Graham-Stewart C W. Haemorrhoids - postulated pathogenesis and proposed prevention. Post Grad Med J. 1975;51:631–636. [PMC free article: PMC2496194] [PubMed: 1105503]
Wannas H R. Pathogenesis and management of prolapsed haemorrhoids. J Roy Coll Surg (Edinburgh) 1984;29:31–37. [PubMed: 6707990]
Mazier W P. Hemorrhoids, fissures and pruritus ani. Surg Clin North Am. 1994;74:1277–1292. [PubMed: 7985064]
Thomson WH. Haemorrhoids. In: Morris PJ, Malt RA (eds.) Oxford Textbook of Surgery 1994; Oxford Medical Publications New York Oxford 1994: 1125–1136 .
Khubchandani I T. A randomized comparison of single and multiple rubber band ligations. Dis Colon Rectum. 1983;26:705–708. [PubMed: 6354644]
Poon G P, Chu K W, Lau W Y, Lee J M H, Yeung C, Fan S T, Yiu T F, Wong S H, Wong K K. Conventional vs. triple rubber band ligation for hemorrhoids. Dis Colon Rectum. 1986;29:836–838. [PubMed: 3539557]
Gartell P C, Sheridan R J, McGinn F P. Out-patient treatment of haemorrhoids: a randomized clinical trial to compare rubber band ligation with phenol injection. Br J Surg. 1985;72:478–479. [PubMed: 3893619]
Sim A J W, Murie J A, Mackenzie I. Comparison of rubber band ligation and sclerosant injection for first and second degree haemorrhoids - a prospective clinical trial. Acta Chir Scand. 1981;147:717–720. [PubMed: 7046318]
Greca F, Hares M M, Nevah E, Alexander-Williams J, Keighley M R B. A randomized trial to compare rubber band ligation with phenol injection for treatment of haemorrhoids. Br J Surg. 1981;68:250–252. [PubMed: 7225738]
Leicester R J, Nicholls R J, Mann C V. Infrared coagulation: a new treatment for hemorrhoids. Dis Colon Rectum. 1981;24:602– 605. [PubMed: 7318625]
Ambrose N S, Hares M M, Alexander-Williams J, Keighley M R. Prospective randomised comparison of photocoagulation and rubber band ligation in treatment of haemorrhoids. Br Med J. 1983;286:1389–91. [PMC free article: PMC1547885] [PubMed: 6404472]
Templeton J L, Spence R A, Kennedy T L, Parks T G, Mackenzie G, Hanna W A. Comparison of infrared coagulation and rubber band ligation for first and second degree haemorrhoids: a randomised prospective clinical trial. Br Med J. 1983;286:1387–9. [PMC free article: PMC1547877] [PubMed: 6404471]
Walker A J, Leicester R J, Nicholls R J, Mann C V. A prospective study of infrared coagulation, injection and rubber band ligation in the treatment of haemorrhoids. Int J Colorectal Dis. 1990;5:113–6. [PubMed: 2358736]
Ambrose N S, Morris D, Alexander-Williams J, Keighley M R B. A randomized trial of photocoagulation or injection sclerotherapy for the treatment of first- and second-degree hemorrhoids. Dis Colon Rectum. 1985;28:238–240. [PubMed: 3884297]
Varma J S, Chung S C, Li A K. Prospective randomised comparison of current coagulation and injection sclerotherapy for the outpatient treatment of haemorrhoids. Int J Colorectal. 1991;6:42–5. [PubMed: 2033353]
Dennison A, Whiston R J, Rooney S, Chadderton R D, Wherry D C, Morris D L. A randomized comparison of infrared coagulation with bipolar diathermy for the outpatient treatment of hemorrhoids. Dis Colon Rectum. 1990;33:32–4. [PubMed: 2403905]
Forster C F, Sussmann H E, Patzelt-Wenczler R. Optimization of the Barron ligature treatment of 2nd and 3rd degree hemorrhoids using a therapeutic troika. Schweiz Rundsch Med Prax. 1996;12:1476–81. [PubMed: 8984570]
Umpleby H C, Britton D C. Manual dilatation of the anus and elastic band ligature: an effective short stay alternative to formal haemorrhoidectomy for prolapsing haemorrhoids. Ann R Coll Surg Engl. 1983;65:378–9. [PMC free article: PMC2494431] [PubMed: 6638853]
MacRae H M, McLeod R S. Comparison of hemorrhoidal treatments: a meta-analysis. Can J Surg. 1997;40:14–7. [PMC free article: PMC3949873] [PubMed: 9030078]
Keighley M R, Buchmann P, Minervini S, Arabi Y, Alexander-Willimas J. Prospective trials of mino surgical procedures and high-fibre diet for haemorrhoids. Br Med J. 1979;20:967–9. [PMC free article: PMC1596562] [PubMed: 389346]
Cheng F C, Shum D W, Ong G B. The treatment of second degree haemorrhoids by injection, rubber band ligation, maximal anal dilatation, and haemorrhoidectomy: a prospective clinical trial. Aust N Z J Surg. 1981;51:458–62. [PubMed: 7032489]
Mortensen P E, Olsen J, Pedersen I K, Christiansen J. A randomized study on hemorrhoidectomy combined with anal dilatation. Dis Colon Rectum. 1987;30:755–757. [PubMed: 3308368]
Hiltunen K M, Matikainen M. Anal dilatation, lateral subcutaneous sphincterotomy and haemorrhoidectomy for the treatment of second and third degree haemorrhoids. A prospective randomized study. Int Surg. 1992;77:261–3. [PubMed: 1478806]
Konsten J, Baeten C G. Hemorrhoidectomy vs. Lord's method: 17 year follow-up of a prospective, randomized trial. Dis Colon Rectum. 2000;43:503–6. [PubMed: 10789746]
Asfar S K, Juma T H, Ala-Edeen T. Hemorrhoidectomy and sphincterotomy. A prospective study comparing the effectiveness of anal stretch and sphincterotomy in reducing pain after hemorrhoidectomy. Dis Colon Rectum. 1988;31:181–185. [PubMed: 2894934]
Mathai V, Ong B C, Ho Y H. Randomized controlled trial of lateral internal sphincterotomy with haemorrhoidectomy. Br J Surg. 1996;83:380–2. [PubMed: 8665199]
Galizia G, Lieto E, Castellano P, Pelosio L, Imperatore V, Pigantelli C. Lateral internal sphincterotomy together with haemorrhoidectomy for treatment of haemorrhoids: a randomised prospective study. Eur J Surg. 2000;166:223–8. [PubMed: 10755337]
Roe A M, Bartolo D C, Velacott K D, Locke-Edmunds J, Mortensen N J. Submucosal versus ligation excision haemorrhoidectomy: a comparison of anal sensation, anal sphincter manometry and postoperative pain and function. Br J Surg. 1987;74:948–51. [PubMed: 3664229]
Seow-Choen F, Ho Y H, Ang H G, Goh H S. Prospective randomized trial comparing pain and clinical function after conventional scissors excision/ligation vs. diathermy excision without ligation for symptomatic prolapsed hemorrhoids. Dis Colon Rectum. 1992;35:1165–9. [PubMed: 1473420]
Bassi R, Bergami G. The surgical treatment of hemorrhoids: diathermocoagulation and traditional technics. A prospective randomized study. Minerva Chir. 1997;52:387–91. [PubMed: 9265122]
Ho Y H, Seow-Choen F, Tan M, Leong A F P K. Randomized controlled trial of open and closed haemorrhoidectomy. Br J Surg. 1997;84:1729–1730. [PubMed: 9448627]
Ibrahim S, Tsang C, Lee Y L, Eu K W, SeowChoen F. Prospective, randomized trial comparing pain and complications between diathermy and scissors for closed hemorrhoidectomy. Dis Colon Rectum. 1998;41:1418–1420. [PubMed: 9823809]
Carapeti E A, Kamm M A, McDonald P J, Chadwick S J, Phillips R K. Randomized trial of open versus closed day-case haemorrhoidectomy. Br J Surg. 1999;86:612–3. [PubMed: 10361179]
Cheetham M J, Mortensen N J M, Nystrom P O, Kamm M A, Phillips R K S. Persistent pain and faecal urgency after stapled haemorrhoidectomy. Lancet. 2000;356:730–33. [PubMed: 11085693]
Mehigan B J, Monson J R T, Hartley J E. Stapling procedure for haemorrhoids versus Milligan-Morgan haemorrhoidectomy: randomised controlled trial. Lancet. 2000;355:782–85. [PubMed: 10711925]
Rowsell M, Bello M, Hemingway D M. Circumferential mucosectomy (stapled haemorrhoidectomy) versus conventional haemorrhoidectomy: randomised controlled trial. Lancet. 2000;355:779–81. [PubMed: 10711924]
Molloy R G, Kingsmore D. Life threatening pelvic sepsis after stapled haemorrhoidectomy. Lancet. 2000;355:810. [PubMed: 10711934]
London N J, Bramley P D, Windle R. Effect of four days of preoperative lactulose on post-haemorrhoidectomy pain: results of placebo controlled trial. Br Med J. 1987;8:363–4. [PMC free article: PMC1247214] [PubMed: 3115449]
Moesgaard F, Nielsen M L, Hansen J B, Knudsen J T. High-fiber diet reduces bleeding and pain in patients with hemorrhoids. A double-blind trial of Vi-Siblin. Dis Colon Rectum. 1982;25:454–456. [PubMed: 6284457]
Ingram M, Wright T A, Ingoldby C J. A prospective randomized study of calcium alginate (Sorbsan) versus standard gauze packing following haemorrhoidectomy. J R Coll Surg Edinb. 1998;43:308–9. [PubMed: 9803099]
Chester J F, Stanford B J, Gazet J C. Analgesic benefit of locally injected bupivacaine after hemorrhoidectomy. Dis Colon Rectum. 1990;33:487–489. [PubMed: 2351001]
Hooker G D, Plewes E A, Rajgopal C, Taylor B M. Local injection of bupivacaine after rubber band ligation of hemorrhoids: prospective, randomized study. Dis Colon Rectum. 1999;42:174–9. [PubMed: 10211492]
Morisaki H, Masuda J, Fukushima K, Iwao Y, Suzuki K, Matushima M. Wound infiltration with lidocaine prolongs postoperative analgesia after haemorrhoidectomy with spinal anaesthesia. Can J Anaesth. 1996;43:914–8. [PubMed: 8874908]
Ho K S, Eu K W, Heah S M, SeowChoen F, Chan Y W. Randomized clinical trial of haemorrhoidectomy under a mixture of local anaesthesia versus general anaesthesia. Br J Surg. 2000;87:410–413. [PubMed: 10759733]
Kilbride M, Morse M, Senagore A. Transdermal Fentanyl improves management of post-operative hemorrhoidectomy pain. Dis Colon Rectum. 1994;37:1070–1072. [PubMed: 7956571]
Luck A J, Hewett P J. Ischiorectal fossa block decreases posthemorrhoidectomy pain: randomized, prospective, double-blind clinical trial. Dis Colon Rectum. 2000;43:142–5. [PubMed: 10696885]
Chiu J H, Chen W S, Chen C H, Jiang J K, Tang G J, Lui W Y, Lin J K. Effect of transcutaneous electrical nerve stimulation for pain relief on patients undergoing hemorrhoidectomy: prospective, randomized, controlled trial. Dis Colon Rectum. 1999;42:180–5. [PubMed: 10211493]
O’Donovan S, Ferrara A, Larach S, Williamson P. Intraoperative use of Toradol facilitates outpatient hemorrhoidectomy. Dis Colon Rectum. 1994;37:793–9. [PubMed: 8055724]
Place R J, Coloma M, White P F, Huber P J, Van Vlymen J, Simmang C L. Ketorolac improves recovery after outpatient anorectal surgery. Dis Colon Rectum. 2000;43:804–8. [PubMed: 10859081]
Pybus D A, D’Bras B E, Goulding G, Liberman H, Torda T A. Postoperative analgesia for haemorrhoid surgery. Anaesth Intensive Care. 1983;11:27–30. [PubMed: 6859504]
Zuckermann M, Panconesi R, Scaricabarozzi I, Nava M L, Bechi P. Clinical efficacy and tolerability of nimesulide compared with naproxen in the treatment of posthaemorrhoidectomy pain and inflammation. Drugs. 1993;46 Suppl 1:177–9. [PubMed: 7506165]
Carapeti E A, Kamm M A, McDonald P J, Phillips R K. Double-blind randomised controlled trial of effect of metronidazole on pain after day-case haemorrhoidectomy. Lancet. 1998;351:169–72. [PubMed: 9449871]
Ho Y H, Seow-Choen F, Low J Y, Tan M, Leong A P K F. Randomized controlled trial of trimebutine (anal sphincter relaxant) for pain after haemorrhoidectomy. Br J Surg. 1997;84:377–379. [PubMed: 9117313]
Aasboe V, Raeder J C, Groegaard B. Betamethasone reduces postoperative pain and nausea after ambulatory surgery. Anesth Analg. 1998;87:319–23. [PubMed: 9706923]
Gottesman L, Milsom J W, Mazier W P. The use of anxiolytic and parasympathomimetic agents in the treatment of postoperative urinary retention following anorectal surgery. Dis Colon Rectum. 1989;32:867–870. [PubMed: 2571469]
Moesgaard F, Nielsen M L, Hansen J B, Knudsen J T. High-fiber diet reduces bleeding and pain in patients with hemorrhoids. A doubleblind trial of Vi-Siblin. Dis Colon Rectum. 1982;25:454–456. [PubMed: 6284457]
Misra M C, Parshad R. Randomized clinical trial of micronized flavonoids in the early control of bleeding from acute internal haemorrhoids. Br J Surg. 2000;87:868–872. [PubMed: 10931020]
Ho Y H, Foo C L, Seow-Choen F, Goh H S. Prospective randomized controlled trial of a micronized flavonidic fraction to reduce bleeding after haemorrhoidectomy. Br J Surg. 1995;82:1034–5. [PubMed: 7648143]
Murie J A, Mackenzie I, Sim A J. Comparison of rubber band ligation and haemorrhoidectomy for second- and third-degree haemorrhoids: a prospective clinical trial. Br J Surg. 1980;67:786–8. [PubMed: 6968608]
Greca F, Nevah E, Hares M, Keighley M R. Value of anal dilatator after anal stretch for haemorrhoids. J R Soc Med. 1981;74:368–70. [PMC free article: PMC1438823] [PubMed: 7017139]
Murie J A, Sim A J W, Mackenzie I. Rubber band ligation versus haemorrhoidectomy for prolapsing haemorrhoids: a long term prospective clinical trial. Br J Surg. 1982;69:536–538. [PubMed: 7049313]
O’Callaghan J D, Matheson T S, Hall R. Inpartient treatment of prolapsing piles: cryosurgery versus Milligan-Morgan haemorrhoidectomy. Br J Surg. 1982;69:157–9. [PubMed: 7066657]
Rasmussen O O, Larsen K G L, Naver L, Christiansen J. Emergency haemorrhoidectomy compared with incision and banding for the treatment of acute strangulated haemorrhoids. Eur J Surg. 1991;157:613–614. [PubMed: 1687254]
Senagore A, Mazier W P, Luchtefeld M A, MacKeigan J M, Wengert T. Treatment of advanced hemorrhoidal disease: a prospective randomized comparison of cold scalpel vs. contact Nd: YAG laser. Dis Colon Rectum. 1993;36:1042–9. [PubMed: 8223057]
Yang R, Migikovsky B, Peicher J, Laine L. Randomized, prospective trial of direct current versus bipolar electrocoagulation for bleeding of internal hemorrhoids. Gastrointest Endosc. 1993;39:766–9. [PubMed: 8293898]
Randall G M, Jensen D M, Machicado G A, Hirabayashi K, Jensen M E, You S, Pelayo E. Prospective randomized comparative study of bipolar versus direct current electrocoagulation for treatment of bleeding of internal hemorrhoids. Gastrointest Endosc. 1994;40:403–10. [PubMed: 7926528]
Chia Y W, Darzi A, Spekman C T, Hill A D, Jameson J S, Henry M M. CO2 laser haemorrhoidectomy - does it alter anorectal function or decrease pain compared to conventional haemorrhoidectomy? Int J Colorectal Dis. 1995;10:22–4. [PubMed: 7745318]
Seow-Choen F, Low H C. Prospective randomized study of radical versus four piles haemorrhoidectomy for symptomatic large circumferential prolapsed piles. Br J Surg. 1995;82:188–9. [PubMed: 7749684]
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