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The Ligation of Prolapsing Bleeding Hemorrhoids: A Simplified Approach to a Benign Disease

The Ligation of Prolapsing Bleeding Hemorrhoids: A Simplified Approach to a Benign Disease Abstract THE RELUCTANCE of patients and physicians alike to submit to excisional hemorrhoidectomy attests to a general dissatisfaction with this therapy. For many patients the greatest deterrents to surgery are pain, loss of time from work, and expensive hospitalization. The intermittency of hemorrhoidal symptoms allows the patient to procrastinate until the pathology is far advanced, at which time surgery may become imperative. This study was undertaken to evaluate ligation as a simple method of treatment for prolapsing bleeding internal hemorrhoids. With this technique the main deterrents to surgery may be largely eliminated. The ligation method of management of internal hemorrhoids was favored by several surgeons in the early 19th century (Salmon1 in 1829); in this method a ligature is placed around the base of an internal pile, allowing the hemorrhoid to infarct and slough out. Excision at the time of ligation was soon practiced as described by Allingham2 in References 1. Salmon, F.: Practical Essays , ed 3, London: Whittaker, Treacher, and Arnot, 1829, pp 208-209. 2. Allingham, W.: Diseases of Rectum , ed 2, London: J. & A. Churchill, 1873, pp 62-132. 3. Hirschman, L.J.: Surgical Treatment of Hemorrhoids , Tr Amer Proctol Soc 27:66-73, 1926. 4. Bacon, H.E.: Anus, Rectum, Sigmoid Colon , ed 3, Philadelphia: J. B. Lippincott Co., 1949, vol 1, p 476. 5. Terrell, E.H.: Treatment of Hemorrhoids by New Method , Tr Amer Proctol Soc 17:65-72, 1916. 6. Blaisdell, P.C.: Prevention of Massive Hemorrhage Secondary to Hemorrhoidectomy , Surg Gynec Obstet 106:485-487, 1958. 7. Barron, J.: Office Ligation of Internal Hemorrhoids , Amer J Surg 105:563-570, 1963.Crossref 8. Fleming, A.J.: Return to Work After Surgery: Industrial Study , Ann NY Acad Sci 73:509-516, 1958.Crossref 9. Gold, D.: Early Ambulation and Return to Full Duty in United States Air Force , Ann NY Acad Sci 73:517-523, 1958.Crossref 10. Saffeir, H.J.: Duration of Surgical Convalescence as Indicated by Insurance Statistics , Ann NY Acad Sci 73:444-454, 1958.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

The Ligation of Prolapsing Bleeding Hemorrhoids: A Simplified Approach to a Benign Disease

Archives of Surgery , Volume 91 (3) – Sep 1, 1965

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Publisher
American Medical Association
Copyright
Copyright © 1965 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1965.01320150093015
Publisher site
See Article on Publisher Site

Abstract

Abstract THE RELUCTANCE of patients and physicians alike to submit to excisional hemorrhoidectomy attests to a general dissatisfaction with this therapy. For many patients the greatest deterrents to surgery are pain, loss of time from work, and expensive hospitalization. The intermittency of hemorrhoidal symptoms allows the patient to procrastinate until the pathology is far advanced, at which time surgery may become imperative. This study was undertaken to evaluate ligation as a simple method of treatment for prolapsing bleeding internal hemorrhoids. With this technique the main deterrents to surgery may be largely eliminated. The ligation method of management of internal hemorrhoids was favored by several surgeons in the early 19th century (Salmon1 in 1829); in this method a ligature is placed around the base of an internal pile, allowing the hemorrhoid to infarct and slough out. Excision at the time of ligation was soon practiced as described by Allingham2 in References 1. Salmon, F.: Practical Essays , ed 3, London: Whittaker, Treacher, and Arnot, 1829, pp 208-209. 2. Allingham, W.: Diseases of Rectum , ed 2, London: J. & A. Churchill, 1873, pp 62-132. 3. Hirschman, L.J.: Surgical Treatment of Hemorrhoids , Tr Amer Proctol Soc 27:66-73, 1926. 4. Bacon, H.E.: Anus, Rectum, Sigmoid Colon , ed 3, Philadelphia: J. B. Lippincott Co., 1949, vol 1, p 476. 5. Terrell, E.H.: Treatment of Hemorrhoids by New Method , Tr Amer Proctol Soc 17:65-72, 1916. 6. Blaisdell, P.C.: Prevention of Massive Hemorrhage Secondary to Hemorrhoidectomy , Surg Gynec Obstet 106:485-487, 1958. 7. Barron, J.: Office Ligation of Internal Hemorrhoids , Amer J Surg 105:563-570, 1963.Crossref 8. Fleming, A.J.: Return to Work After Surgery: Industrial Study , Ann NY Acad Sci 73:509-516, 1958.Crossref 9. Gold, D.: Early Ambulation and Return to Full Duty in United States Air Force , Ann NY Acad Sci 73:517-523, 1958.Crossref 10. Saffeir, H.J.: Duration of Surgical Convalescence as Indicated by Insurance Statistics , Ann NY Acad Sci 73:444-454, 1958.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Sep 1, 1965

References