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Cardiology583 papers

Hemorrhoids

Last edited: 4/23/2026

Overview

Hemorrhoids are common anorectal conditions characterized by enlarged veins in the lower rectum or anus, often causing symptoms such as pain, bleeding, and prolapse. They significantly impact healthcare spending and quality of life globally 310.

Diagnosis

  • Clinical Presentation: Presence of bleeding, pain, swelling, and protrusion 3.
  • Grading:
  • - Grade I: Hemorrhoids bleed but do not prolapse. - Grade II: Prolapse upon defecation but reduce spontaneously. - Grade III: Require manual reduction after prolapse. - Grade IV: Permanently prolapsed 320.
  • Diagnostic Tests:
  • - Digital rectal examination. - Anoscopy or proctoscopy for visualization 3.

    Management

  • First-Line Treatments:
  • - Conservative Management: Dietary modifications, increased fiber intake, stool softeners 3. - Non-Surgical: Rubber band ligation, sclerotherapy (e.g., 3% polidocanol foam), infrared coagulation 31131.
  • Surgical Interventions:
  • - Stapled Hemorrhoidopexy (PPH) for grades II-IV 921. - Open Excisional Hemorrhoidectomy (Milligan-Morgan) for advanced cases 1529. - Transanal Hemorrhoidal Dearterialization (THD) with mucopexy for grades III-IV 2029.
  • Adjunctive Treatments:
  • - Methylene blue infiltrating injection to reduce postoperative pain 8. - Botulinum toxin injection for post-operative pain management 55. - Topical anesthetics for pain relief during procedures like banding 42.

    Special Populations

  • Pregnancy: Conservative treatments preferred; sitz baths and ano-rectal creams effective 66.
  • Elderly: Higher risk of complications; minimally invasive techniques recommended 4449.
  • Comorbidities: Consider bleeding risk with anticoagulants; monitor closely post-surgery 32.
  • Key Recommendations

  • Use Transanal Hemorrhoidal Dearterialization (THD) for Grade III-IV Hemorrhoids: Effective with lower complication rates compared to traditional excisional methods 2029 (Evidence: Strong).
  • Consider Stapled Hemorrhoidopexy (PPH) for Grade II-IV Hemorrhoids: Less invasive alternative with comparable outcomes to open surgery 921 (Evidence: Moderate).
  • Implement Conservative Management Initially for Grade I-II Hemorrhoids: Including dietary changes and non-surgical interventions like rubber band ligation 311 (Evidence: Moderate).
  • Monitor and Manage Bleeding Risk in Patients on Antithrombotic Therapy: Due to increased risk of postoperative bleeding complications 32 (Evidence: Moderate).
  • Utilize Minimally Invasive Techniques in Elderly Patients: To reduce complication rates and improve recovery 4449 (Evidence: Moderate).
  • References

    Showing 100 most recent of 498 indexed papers.

    1 Bilgiç Ç, Bölük S, Sobutay E, Bayraktar B. Clinical outcomes of arterial detection ligation technique for grade II/III versus grade IV hemorrhoidal disease. Medicine 2026. link 2 Fan J, Qi S, Jin X. Comparison of Mayinglong musk hemorrhoids ointment and musk hemorrhoids suppository on postoperative pain and healing in mixed hemorrhoids after PPH or RPH. Pakistan journal of pharmaceutical sciences 2026. link 3 Egawa F, Gologorsky RC. Hemorrhoids. The Surgical clinics of North America 2026. link 4 Do TT, Pham PK, Nguyen TL, Pham TTH, Le NH, Nguyen DT et al.. Surgical management of anal stenosis following hemorrhoid treatment: a single-center case series. International journal of colorectal disease 2026. link 5 Sun H, Xu W, Gao J, Wang I, Tian M, Qi W et al.. Comparison of the modeling effects between two hemorrhoid models. Techniques in coloproctology 2026. link 6 Gao X, Hu M, Hu M. Comparative efficacy of Ma Yinglong ointment and Gangtai suppository for hemorrhoids: A retrospective cohort study. Pakistan journal of pharmaceutical sciences 2026. link 7 Syaifulanwar A, Pajrianti L, Yulis Hamidy M, Ismawati I, Darmawi D, Muhammad Irham L et al.. Integrative genomic analysis of missense mutations and target genes in hemorrhoid pathogenesis. Folia medica 2026. link 8 Zhu J, Deng H, Li M, Tang K. The effect of methylene blue infiltrating injection on anal pain after Milligan-Morgan surgery: A randomized controlled clinical study. Medicine 2026. link 9 Alam MM, Rahman MS, Ferdaus MAM, Antara FY, Hossain MM, Rahman MMH et al.. Perioperative and Postoperative Complications Associated with Stapled Hemorrhoidopexy. Mymensingh medical journal : MMJ 2026. link 10 Esmaeilnia Shirvani A, Pakdaman K, Maleki Z, Soraneh S, Rezaei Chegini F, Pakdaman K et al.. Worldwide prevalence of haemorrhoids: a systematic review and meta-analysis. Annals of medicine 2026. link 11 Dai X, Gu Z, Deng X, You W, Cao T, Zhang L et al.. Flexible endoscopic treatment of internal hemorrhoids with versus without intravenous anesthesia: a retrospective study of 559 cases. Surgical endoscopy 2026. link 12 Martins MAB, Almeida LFC, Cappellaro AP, Rocha LFR, Nobrega Oliveira REND. Operative versus nonoperative treatment of thrombosed external hemorrhoids: a systematic review and meta-analysis. Updates in surgery 2026. link 13 Lee ML, Kao YW, Yang YT, Chen MC, Shia BC, Huang SY et al.. The bidirectional association between hemorrhoidal disease and varicose veins: a nationwide population-based cohort study. International journal of colorectal disease 2025. link 14 Amangalieva G, Ivic-Britt RK, Carmack HJ, Holiday S. Belonging, Affirmation, Safety, and Efficacy (BASE): An Integrative Model for Shame Resilience, Social Support, and Humor in r/hemorrhoid. Health communication 2025. link 15 Mustapha B, Alatise OI, Olasehinde O, Adisa A, Wuraola FO, Mohammed TO et al.. LigaSure versus conventional Milligan MORGAN hemorrhoidectomy in Nigerian patients with symptomatic hemorrhoids. World journal of surgery 2025. link 16 Fernandez-Hurtado I, Pages-Valle N, Sarubbo MF, Claramonte-Bellmunt O, Baena-Bradaschia S, Cifuentes-Rodenas JA et al.. Open excisional haemorrhoidectomy versus transanal haemorrhoidal dearterialization for grade III haemorrhoids: open-label randomized clinical trial. The British journal of surgery 2025. link 17 Hua HW, Wu J. Transverse incision with longitudinal ligation procedure: Innovation, pitfalls, and clinical perspectives. World journal of gastroenterology 2025. link 18 Zakaria R, Amin MM, Abo-Alella HA, Hegab YH. Laser hemorrhoidoplasty versus hemorrhoidectomy in the treatment of surgically indicated hemorrhoids in inflammatory bowel patients: a randomized comparative clinical study. Surgical endoscopy 2025. link 19 . Best clinical practice recommendations for the management of symptomatic hemorrhoids via laser hemorrhoidoplasty: the LHP recommendations. Techniques in coloproctology 2024. link 20 Puigdollers A, de Balle M, Rovira-Argelagues M. Haemorrhoidal artery distribution in patients with grade III and IV haemorrhoids treated with artery ligation and rectoanal repair. Assessment of Doppler guidance. Cirugia espanola 2024. link 21 Nada MAM, Awad PBA, Kirollos AMA, Abdelaziz MM, Mohamed KMS, Awad KBA et al.. Comparison between stapled hemorrhoidopexy and harmonic scalpel hemorrhoidectomy in the management of third- and fourth-degree piles: a randomized clinical trial. Chirurgie (Heidelberg, Germany) 2024. link 22 Pekacar S, Özüpek B, Akkol EK, Taştan H, Ersan H, Orhan DD. Identification of bioactive components on antihemorrhoidal activity of Cistus laurifolius L. using RP-HPLC and LC-QTOF-MS. Journal of ethnopharmacology 2024. link 23 Ihle C, Zawadzki A. Transanal open haemorrhoidopexy: a well-tolerated, minimally invasive surgical method for haemorrhoids grade II to IV. ANZ journal of surgery 2024. link 24 Yu Q, Zhao Y, Zhang X, Li W, Zhang H, Piao S et al.. The beneficial effect of Sanhuang ointment and its active constituents on experimental hemorrhoids in rats. Journal of ethnopharmacology 2024. link 25 Akinmoladun O, Oh W. Management of Hemorrhoids and Anal Fissures. The Surgical clinics of North America 2024. link 26 Medkova Y, Tulina I, Novikov I, Nikonov A, Ischenko A, Aleksandrov L et al.. Thrombosed external hemorrhoids during pregnancy: surgery versus conservative treatment. Updates in surgery 2024. link 27 Cemil A, Ugur K, Salih GM, Merve K, Guray DM, Emine BS. Comparison of Laser Hemorrhoidoplasty and Milligan-Morgan Hemorrhoidectomy Techniques in the Treatment of Grade 2 and 3 Hemorrhoidal Disease. The American surgeon 2024. link 28 Eid M, Bastien A, Shaw R, Goodman DC, Ivatury SJ. Regional Differences in Procedural Care of Hemorrhoid Management in Medicare Patients; Unwarranted Variation in Clinical Practice for a Medical-First Problem. The Journal of surgical research 2023. link 29 Trenti L, Biondo S, Espin-Basany E, Barrios O, Sanchez-Garcia JL, Landaluce-Olavarria A et al.. Transanal Hemorrhoidal Dearterialization With Mucopexy Versus Vessel-Sealing Device Hemorrhoidectomy for Grade III to IV Hemorrhoids: Long-term Outcomes From the THDLIGA Randomized Controlled Trial. Diseases of the colon and rectum 2023. link 30 Feo CF, Ninniri C, Tanda C, Deiana G, Porcu A. Open Hemorrhoidectomy With Ligasure™ Under Local or Spinal Anesthesia: A Comparative Study. The American surgeon 2023. link 31 Gallo G, Picciariello A, Pietroletti R, Novelli E, Sturiale A, Tutino R et al.. Sclerotherapy with 3% polidocanol foam to treat second-degree haemorrhoidal disease: Three-year follow-up of a multicentre, single arm, IDEAL phase 2b trial. Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland 2023. link 32 Dean KR, Pavuluri H, Fox S, Tan X, Watson B, Wallenborn JG et al.. The Impact of Antithrombotic Medications on Postoperative Bleeding Events Following Hemorrhoidectomy. The American surgeon 2023. link 33 Sninsky JA, Galanko J, Sandler RS, Peery AF. Diverticulosis Is Associated With Internal Hemorrhoids on Colonoscopy: Possible Clues to Etiology. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association 2023. link 34 Colley A, Finlayson E, Zhao S, Boscardin J, Suskind A. High risk of complications after a "low risk" procedure: A national study of nursing home residents and older adults undergoing haemorrhoid surgery. Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland 2023. link 35 Lie H, Lukito PP, Sudirman T, Purnama AA, Sutedja R, Setiawan A et al.. Utility of botulinum toxin injection for post-operative pain management after conventional hemorrhoidectomy: a systematic review and meta-analysis of clinical trials. Scandinavian journal of gastroenterology 2023. link 36 Huang H, Tao L, Jiang J, Wei J, Ji L. Tissue-selecting-technique mega-window stapler combined with anal canal epithelial preservation operation in prolapsed hemorrhoids. Asian journal of surgery 2023. link 37 Girling C, Lee MJ, Vimalchandran D, Jayne DJ, Stancliffe S, Wailoo A et al.. Protocol for the ORION trial (RadiO fRequency ablatION for haemorrhoids): a randomised controlled trial. Techniques in coloproctology 2023. link 38 Cuglan B, Ozturk S, Ozcan F, Atmaca H, Ensaroğlu F, Saçıkara A et al.. Assessment of venous leg symptoms in patients with hemorrhoidal disease (VEIN-HEMORRHOID study). Phlebology 2022. link 39 Song X, Sun W, Bao Y, Tu J, Zhang T. Outcome of a modified Park's submucosal hemorrhoidectomy versus Milligan-Morgan for grade III-IV circumferential prolapsed hemorrhoids. Asian journal of surgery 2022. link 40 Liu L, Wei G, Xu Q, Zhang C, Zhang C, Meng L et al.. Photodynamic therapy in the treatment of perianal condyloma acuminatum with hemorrhoids: A report of two cases. Photodiagnosis and photodynamic therapy 2022. link 41 Zhai M, Wu Y, Xu R, Zhang Z. Evaluation of clinical efficacy of suture-fixation mucopexy in the treatment of prolapsed hemorrhoid. Minerva surgery 2022. link 42 Sharma V, Sharma D, Stearns A, Hernon J. The use of topical anaesthetic in the banding of internal haemorrhoids: a feasibility study for a randomised control trial. Annals of the Royal College of Surgeons of England 2022. link 43 Feyen L, Freyhardt P, Schott P, Wullstein C, Dimitriou-Zarra A, Katoh M. Embolization of Hemorrhoidal Arteries: A Novel Endovascular Therapy Option for the Treatment of Hemorrhoidal Disease. RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin 2022. link 44 Deng K, Ding Z, Li J. Medical insurance and physician-induced demand in China: the case of hemorrhoid treatments. International journal of health economics and management 2022. link 45 Kusumawati I, Rullyansyah S, Rohmania, Rizka AF, Hestianah EP, Matsunami K. Histomorphometric study of ethanolic extract of Graptophyllum pictum (L.) Griff. leaves on croton oil-induced hemorrhoid mice: A Javanese traditional anti-hemorrhoid herb. Journal of ethnopharmacology 2022. link 46 Didelot JM, Didelot R. Radiofrequency thermocoagulation of haemorrhoidal bundles, an alternative technique for the management of internal haemorrhoids. International journal of colorectal disease 2021. link 47 Longchamp G, Liot E, Meyer J, Toso C, Buchs NC, Ris F. Non-excisional laser therapies for hemorrhoidal disease: a systematic review of the literature. Lasers in medical science 2021. link 48 Drissi F, Jean MH, Abet E. Evaluation of the efficacy and morbidity of radiofrequency thermocoagulation in the treatment of hemorrhoidal disease. Journal of visceral surgery 2021. link 49 Patel R, Rehman A, Baig M, Kazem MA, Khan A. A cohort study analysing outcomes following transanal haemorrhoidal dearterialisation (THD). The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland 2021. link 50 Yoshimitsu M, Egi H, Kaneko M, Shimomura M, Hakoda K, Miguchi M et al.. Laparoscopic anterior resection for rectal stenosis caused by ALTA injection for internal hemorrhoids: A case report. Asian journal of endoscopic surgery 2021. link 51 Lobascio P, Laforgia R, Novelli E, Perrone F, Di Salvo M, Pezzolla A et al.. Short-Term Results of Sclerotherapy with 3% Polidocanol Foam for Symptomatic Second- and Third-Degree Hemorrhoidal Disease. Journal of investigative surgery : the official journal of the Academy of Surgical Research 2021. link 52 Zenger S, Gurbuz B, Can U, Yalti T. A new technique of doppler dearterialization for hemorrhoidal disease: arterial detection ligation (ADL). Surgery today 2021. link 53 Klang E, Sobeh T, Amitai MM, Apter S, Barash Y, Tau N. Post hemorrhoidectomy complications: CT imaging findings. Clinical imaging 2020. link 54 Zhang G, Liang R, Wang J, Ke M, Chen Z, Huang J et al.. Network meta-analysis of randomized controlled trials comparing the procedure for prolapse and hemorrhoids, Milligan-Morgan hemorrhoidectomy and tissue-selecting therapy stapler in the treatment of grade III and IV internal hemorrhoids(Meta-analysis). International journal of surgery (London, England) 2020. link 55 Brusciano L, Gambardella C, Terracciano G, Gualtieri G, Schiano di Visconte M, Tolone S et al.. Postoperative discomfort and pain in the management of hemorrhoidal disease: laser hemorrhoidoplasty, a minimal invasive treatment of symptomatic hemorrhoids. Updates in surgery 2020. link 56 Krebs ED, Zhang AY, Hassinger TE, Suraju MO, Berry PS, Hoang SC et al.. Preoperative bleeding requiring transfusion: An under-reported indication for hemorrhoidectomy. American journal of surgery 2020. link 57 Ala S, Alvandipour M, Saeedi M, Mansourifar M, Monajati M, Shiva A. Effect of Topical Baclofen 5% on Post-Hemorrhoidectomy Pain: Randomized Double Blind Placebo-Controlled Clinical Trial. Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract 2020. link 58 Eberspacher C, Mascagni D, Antypas P, Grimaldi G, Fralleone L, Pontone S et al.. External hemorrhoidal thrombosis in the elderly patients: conservative and surgical management. Minerva chirurgica 2020. link 59 Xia W, MacFater WS, Barazanchi AWH, Sammour T, Hill AG. Risk factors associated with unplanned readmission following excisional haemorrhoidectomy. Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland 2020. link 60 Bashir Y, McGovern B, Tahtouh M, Abbasi T, Murphy M, Neary P. Coloproctology procedure clinic: a novel service developed to reduce suffering of patients with bleeding per rectum. Irish journal of medical science 2019. link 61 Shi Y, Yang D, Chen S, Wang S, Li H, Ying J et al.. Factors influencing patient delay in individuals with haemorrhoids: A study based on theory of planned behavior and common sense model. Journal of advanced nursing 2019. link 62 Freymond JM, Chautems R, Della Santa V, Wolter L. [Proctological emergencies in pregnant women]. Revue medicale suisse 2018. link 63 Yeh ML, Chung YC, Hsu LC, Hung SH. Effect of Transcutaneous Acupoint Electrical Stimulation on Post-Hemorrhoidectomy-Associated Pain, Anxiety, and Heart Rate Variability: A Randomized-Controlled Study. Clinical nursing research 2018. link 64 Nadri S, Mahmoudvand H, Rokrok S, Tarrahi MJ. Comparison of Two Methods: Spinal Anesthesia and Ischiorectal Block on Post Hemorrhoidectomy Pain and Hospital Stay: A Randomized Control Trial. Journal of investigative surgery : the official journal of the Academy of Surgical Research 2018. link 65 Ul Ain Q, Bashir Y, Eguare E. Evaluation of the effectiveness and patients' contentment with transanal haemorrhoidal artery dearterialisation and mucopexy (THD) for treatment of haemorrhoidal disease: a 6-year study. Irish journal of medical science 2018. link 66 Shirah BH, Shirah HA, Fallata AH, Alobidy SN, Hawsawi MMA. Hemorrhoids during pregnancy: Sitz bath vs. ano-rectal cream: A comparative prospective study of two conservative treatment protocols. Women and birth : journal of the Australian College of Midwives 2018. link 67 Milito G, Lisi G, Aronadio E, Campanelli M, Venditti D, Grande S et al.. LigasureTM hemorrhoidectomy: how we do. Minerva gastroenterologica e dietologica 2017. link 68 Naderan M, Shoar S, Nazari M, Elsayed A, Mahmoodzadeh H, Khorgami Z. A Randomized Controlled Trial Comparing Laser Intra-Hemorrhoidal Coagulation and Milligan-Morgan Hemorrhoidectomy. Journal of investigative surgery : the official journal of the Academy of Surgical Research 2017. link 69 Talha A, Bessa S, Abdel Wahab M. Ligasure, Harmonic Scalpel versus conventional diathermy in excisional haemorrhoidectomy: a randomized controlled trial. ANZ journal of surgery 2017. link 70 Schiano di Visconte M, Nicolì F, Del Giudice R, Cipolat Mis T. Effect of a mixture of diosmin, coumarin glycosides, and triterpenes on bleeding, thrombosis, and pain after stapled anopexy: a prospective, randomized, placebo-controlled clinical trial. International journal of colorectal disease 2017. link 71 Milito G, Lisi G, Aronadio E, Campanelli M, Venditti D, Grande S et al.. May radiofrequency be the best choice for III-IV degree hemorrhoids?. Minerva gastroenterologica e dietologica 2017. link 72 Loganathan A, Das A, Luck A, Hewett P. Transanal haemorrhoidal dearterialization for the treatment of grade III and IV haemorrhoids: a 3-year experience. ANZ journal of surgery 2016. link 73 Serra R, Gallelli L, Grande R, Amato B, De Caridi G, Sammarco G et al.. Hemorrhoids and matrix metalloproteinases: A multicenter study on the predictive role of biomarkers. Surgery 2016. link 74 Holdstock JM, Dos Santos SJ, Harrison CC, Price BA, Whiteley MS. Haemorrhoids are associated with internal iliac vein reflux in up to one-third of women presenting with varicose veins associated with pelvic vein reflux. Phlebology 2015. link 75 Lim SS, Yu CW, Aw LD. Comparing topical hydrocortisone cream with Hai's Perianal Support in managing symptomatic hemorrhoids in pregnancy: a preliminary trial. The journal of obstetrics and gynaecology research 2015. link 76 Sultan S. Longo procedure (Stapled hemorrhoidopexy): Indications, results. Journal of visceral surgery 2015. link 77 Moult HP, Aubert M, De Parades V. Classical treatment of hemorrhoids. Journal of visceral surgery 2015. link 78 Vidal V, Sapoval M, Sielezneff Y, De Parades V, Tradi F, Louis G et al.. Emborrhoid: a new concept for the treatment of hemorrhoids with arterial embolization: the first 14 cases. Cardiovascular and interventional radiology 2015. link 79 Vinson-Bonnet B, Higuero T, Faucheron JL, Senejoux A, Pigot F, Siproudhis L. Ambulatory haemorrhoidal surgery: systematic literature review and qualitative analysis. International journal of colorectal disease 2015. link 80 Tsunoda A, Kiyasu Y, Fujii W, Kano N. Comparison of the early results of transanal hemorrhoidal dearterialization and hemorrhoidectomy using an ultrasonic scalpel. Surgery today 2015. link 81 Nasseri YY, Krott E, Van Groningen KM, Berho M, Osborne MC, Wollman S et al.. Abnormalities in collagen composition may contribute to the pathogenesis of hemorrhoids: morphometric analysis. Techniques in coloproctology 2015. link 82 Ratto C, de Parades V. Doppler-guided ligation of hemorrhoidal arteries with mucopexy: A technique for the future. Journal of visceral surgery 2015. link 83 Grossmann O, Soccorso G, Murthi G. LigaSure Hemorrhoidectomy for Symptomatic Hemorrhoids: First Pediatric Experience. European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift fur Kinderchirurgie 2015. link 84 Champagne BJ, Stein SL, Haridas M, Ermlich B, Hoffman L, Lee J et al.. Novel operative anoscope for Ferguson hemorrhoidectomy: a feasibility study and comparative cohort analysis. Surgical innovation 2015. link 85 Bilgin Y, Hot S, Barlas İS, Akan A, Eryavuz Y. Short- and long-term results of harmonic scalpel hemorrhoidectomy versus stapler hemorrhoidopexy in treatment of hemorrhoidal disease. Asian journal of surgery 2015. link 86 Noguerales F, Díaz R, Salim B, Piniella F, Landaluce A, Garcea A et al.. Treatment of haemorrhoids by transanal haemorrhoidal dearterialization. Experience of several specialized units. Cirugia espanola 2015. link 87 Ratto C. THD Doppler procedure for hemorrhoids: the surgical technique. Techniques in coloproctology 2014. link 88 Tempel MB, Pearson EG, Page M, Pollock D, Gilmore-Lynch K, Peche W et al.. Survey of patient satisfaction after Doppler-guided transanal hemorrhoidal dearterialization performed in ambulatory settings. Techniques in coloproctology 2014. link 89 Qarabaki MA, Mukhashavria GA, Mukhashavria GG, Giorgadze NG. Circular vs. three-quadrant hemorrhoidectomy for end-stage hemorrhoids: short- and long-term outcomes of a prospective randomized trial. Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract 2014. link 90 Chen CW, Lai CW, Chang YJ, Hsiao KH. Modified LigaSure hemorrhoidectomy for the treatment of hemorrhoidal crisis. Surgery today 2014. link 91 Rakinic J, Poola VP. Hemorrhoids and fistulas: new solutions to old problems. Current problems in surgery 2014. link 92 Yano T, Asano M, Tanaka S, Oda N, Matsuda Y. Prospective study comparing the new sclerotherapy and hemorrhoidectomy in terms of therapeutic outcomes at 4 years after the treatment. Surgery today 2014. link 93 Andreuccetti J, Gaj F, Crispino P, Dassatti MR, Negro P. Hemoperitoneum: a rare complication of hemorrhoid treatment. Techniques in coloproctology 2014. link 94 Franceschilli L, D'Ugo S, de Luca E, Cadeddu F, Milito G, di Lorenzo N et al.. Role of 0.4% glyceryl trinitrate ointment after haemorrhoidectomy: results of a prospective randomised study. International journal of colorectal disease 2013. link 95 Chan KK, Arthur JD. External haemorrhoidal thrombosis: evidence for current management. Techniques in coloproctology 2013. link 96 Kamel R, Basha M, Abd El-Alim SH. Development of a novel vesicular system using a binary mixture of sorbitan monostearate and polyethylene glycol fatty acid esters for rectal delivery of rutin. Journal of liposome research 2013. link 97 Pramateftakis MG, Pavlidis L, Koumourtzis M, Sxisas N, Rampiadou C. The use of a detachable anvil enables an easier and safer stapled hemorrhoidopexy. Techniques in coloproctology 2013. link 98 Man KM, Chen WC, Wang HM, Chen HY, Shen JL, Chen LD et al.. A randomized, double-blind, placebo-controlled trial of a Chinese herbal Sophora flower formula in patients with symptomatic haemorrhoids: a preliminary study. African journal of traditional, complementary, and alternative medicines : AJTCAM 2013. link 99 Chen CW, Lai CW, Chang YJ, Chen CM, Hsiao KH. Results of 666 consecutive patients treated with LigaSure hemorrhoidectomy for symptomatic prolapsed hemorrhoids with a minimum follow-up of 2 years. Surgery 2013. link 100 Yamamoto Y, Miwa M. Visualization of diffusion of the drug solution during aluminum potassium tannic acid injection therapy: a pilot study. Surgery today 2013. link

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