• hemorrhoid
• hemorrhoidal crisis
• thrombosed hemorrhoids

• Hemorrhoids
• Minimally invasive surgical procedure
• Quality of life
• Radiofrequency ablation
• Rafaelo procedure

• Hemorrhoids
• Laser hemorrhoidoplasty
• Minimal invasive
• Suture ligation

• Humans
• Hemorrhoids/surgery
• Ligation/methods
• Female
• Retrospective Studies
• Male
• Hemorrhoidectomy/methods
• Hemorrhoidectomy/adverse effects
• Middle Aged
• Treatment Outcome
• Adult
• Pain, Postoperative/etiology
• Laser Therapy/methods
• Suture Techniques
• Aged
• Recurrence
• Postoperative Complications/etiology
• Postoperative Complications/prevention & control
• Patient Satisfaction
• Sutures

• hemorrhage
• internal hemorrhoids
• interventional radiology
• rectal artery embolization
• rectal bleeding

• Milligan-Morgan
• hemorrhoidal disease
• hemorrhoidectomy
• hemorrhoidoplasty
• hemorrhoids
• laser
• rescue analgesia

• Adolescent
• Adult
• Aged
• Humans
• Middle Aged
• Young Adult
• Hemorrhage
• Hemorrhoidectomy/methods
• Hemorrhoids/surgery
• Lasers
• Pain Management
• Pain, Postoperative/etiology
• Male
• Female

• hemorrhoidectomy
• intradermal injection
• methylene blue
• numeric rating scale
• postoperative pain

• Embolization, Therapeutic
• Hemorrhoids
• Mesenteric Artery, Inferior
• Radiology, Interventional
• Rectal diseases

• Male
• Humans
• Adult
• Middle Aged
• Female
• Hemorrhoids/complications
• Hemorrhoids/therapy
• Anal Canal
• Prospective Studies
• Quality of Life
• Treatment Outcome
• Organ Sparing Treatments
• Gastrointestinal Hemorrhage/etiology
• Gastrointestinal Hemorrhage/therapy
• Catheters

• Humans
• Hemorrhoidectomy/adverse effects
• Retrospective Studies
• Hemorrhoids/surgery
• Digestive System Surgical Procedures/methods
• Rectum
• Postoperative Complications/etiology

• Doppler
• Hemorrhoidal disease
• Ligasure hemorrhoidectomy
• Ligation

• Humans
• Male
• Female
• Hemorrhoids/surgery
• Hemorrhoidectomy/adverse effects
• Retrospective Studies
• Prospective Studies
• Treatment Outcome
• Pain, Postoperative/etiology
• Arteries/surgery
• Ligation/methods

• Haemorrhoids
• Radiofrequency ablation
• Rafaelo© procedure
• Surgery

• Male
• Humans
• Middle Aged
• Female
• Hemorrhoids/surgery
• Hemorrhoids/complications
• Quality of Life
• Hemorrhoidectomy/adverse effects
• Pain, Postoperative/etiology
• Radiofrequency Ablation/adverse effects
• Treatment Outcome

• Ramsay Santé

• Complication
• Hemorrhoids
• Milligan-Morgan hemorrhoidectomy (MMH)
• Non-Doppler hemorrhoidal artery ligation (ND-HAL)

• Humans
• Retrospective Studies
• Hemorrhoidectomy/adverse effects
• Hemorrhoids/surgery
• Constriction, Pathologic
• Urinary Retention
• Anorectal Malformations
• Postoperative Hemorrhage
• Blood Loss, Surgical
• Pain, Postoperative/etiology
• Arteries/surgery

• anorectal surgery
• cohort study
• hemorrhoidal artery ligation
• hemorrhoidal disease
• mucopexy

• Hemorrhoids
• Laser ligation
• Outcomes
• Post-operative complications

• Clinical efficacy
• Milligan-Morgan
• Mixed haemorrhoid
• Modified ultrasonic scalpel haemorrhoidectomy
• Safety

• Hemorrhoidal artery ligation
• Hemorrhoids
• Milligan–Morgan hemorrhoidectomy
• Rectoanal repair

Hemorrhoids have a significant incidence in people and are becoming a common public health problem. This study provides a bibliometric and visualized analysis of the most influential literature in the field. The aim is to reveal trends in the field of hemorrhoids and to provide a reference for researchers.

The 100 most frequently cited studies in the field of hemorrhoids were collected from the Web of Science(WOS), and were analyzed in terms of the annual publication, types of literature, countries, institutions, authors, journals, and keywords. During the study, we used a combination of VosViewer, Carrot2, Microsoft Excel, and Tableau tools to better present the visual information.

A total of 4,481 articles were retrieved, of which 3,592 were of the Article and Review types, among which we selected the 100 most frequently cited. A large amount of highly cited literature on hemorrhoid surgery emerged from 1990 to 2010, and the interest of researchers in hemorrhoid surgery seems to have waned after 2010. The sources of highly cited literature in the field of hemorrhoids are predominantly Western, with the United States. and the United Kingdom accounting for almost half of the publications worldwide. However, countries with higher prevalence populations do not have significant research on hemorrhoids. St. Mark's Hospital has published the largest number of influential articles in the field of hemorrhoid disease. Kamm MA and Phillips RKS are the most authoritative authors in the field. Diseases of the Colon & Rectum and the British Journal of Surgery are the most influential journals in this field. The highly cited literature covers a wide range of disciplines, with Thomson's classic “The nature of hemorrhoids” receiving the most attention among the studies focusing on hemorrhoids. Keyword and clustering analysis revealed that The most famous focus in the field of hemorrhoid research is the evolution of stapled hemorrhoidectomy (SH) and Milligan-morgan hemorrhoidectomy (MMH).

This study is the first to explore developments in the field of hemorrhoids, and it helps surgeons quickly understand global trends in the field of hemorrhoids. In recent years, the development of hemorrhoids seems to have hit a bottleneck, with scholarly interest in the field of waning, especially in surgery Procedures. The theory of inferior anal cushion migration has proven to be the most influential theory in the field, but after studies based on SH and MMH, more high-quality evidence is needed to continue advancing the field of hemorrhoids. The results of this study are intended to add to the attention and interest of scholars in this area and provide a reference for further research.

• National Natural Science Foundation of China
• Natural Science Foundation of Fujian Province

• bleeding
• coil embolization
• hemorrhoid
• particle embolization
• superior rectal artery

Recent trends in benign anal disease treatment are minimizing surgery to preserve normal anorectal anatomical unit and its functions. However, some surgeons still prefer and are confident with the use of conventional solid surgical methods. In this report, we will investigate the recent trends in the treatment for hemorrhoids, fistula, and anal fissure. The practice guidelines of advanced countries, including UK, Italy, France, USA, Japan, and ESCP, are referred to in this review. Opinions suggested in international meetings were also added. In the management of hemorrhoids, surgical treatments and office procedures were recommended according to a patient's status and preference. For the management of complex anal fistula, novel sphincter-preserving surgical techniques are more widely accepted than a sphincter-dividing procedure of immediate repair following fistulectomy. The treatment of anal fissures is well covered in the guidelines of the ASCRS.

• long-term follow-up
• minimum pain for hemorrhoids
• short stay
• suture mucopexy

• Carcinoma
• Hemorrhoids/surgery
• Humans
• Pain
• Retrospective Studies
• Sutures

• hemorrhoids
• ligasure
• meta-analysis
• pph

• Hemorrhoidectomy/methods
• Hemorrhoids/surgery
• Humans
• Ligation/instrumentation
• Multicenter Studies as Topic
• Prolapse
• Randomized Controlled Trials as Topic
• Surgical Stapling
• Suture Techniques
• Treatment Outcome

Symptomatic haemorrhoids are a common anorectal disorder. The aim of the study was to investigate whether the omission of tamponade dressings after haemorrhoidectomy reduces postoperative pain without increasing the risk of severe bleeding.

This was an open-label, randomized clinical trial conducted at 14 German hospitals. All patients with third- or fourth-degree haemorrhoids undergoing haemorrhoidectomy were considered eligible for selection in the intervention (no dressing) or control group (tamponade applied). Two co-primary outcomes were analysed by testing hierarchically ordered hypotheses. First, maximum pain intensity within 48 h after surgery was compared between the groups (superiority). This was followed by an analysis of severe bleeding complications, defined as any bleeding requiring surgical re-intervention within 7 days (non-inferiority). Secondary outcomes included health-related quality of life, patient satisfaction, haemoglobin levels, and adverse events.

Out of 950 patients screened, 754 were randomized and 725 received intervention (366 patients in the intervention and 359 patients in the control group). In the group with tamponade dressings, median pain intensity on the 0 to 10 scale was 6 (interquartile range (i.q.r.) 4–7). Patients without tamponade dressings reported significantly less pain (median 5 (i.q.r. 3–7), P < 0.001). In each group, five patients (1.4 per cent) experienced severe bleeding. The absolute difference for the severe bleeding rate was −0.03 per cent with the 90 per cent confidence interval ranging from −1.47 per cent to +1.41 per cent, in line with the non-inferiority aim. No significant between-group difference was found for secondary outcomes.

The practice of inserting tamponade dressings after haemorrhoidectomy correlates with increased postoperative pain and does not provide benefits in terms of reduced postoperative bleeding.

DRKS00011590

• Bandages/adverse effects
• Hemorrhoidectomy/adverse effects
• Hemorrhoids/surgery
• Humans
• Pain, Postoperative/etiology
• Pain, Postoperative/prevention & control
• Quality of Life

• Helios Center for Research and Innovation

Aim: This prospective study aimed to determine the outcomes and postoperative complications of hemorrhoid disease (HD) treated by hemorrhoidal laser procedure (HeLP).

Background: We, herein report the results of 18 months of methodical use of mini-invasive laser procedures in 100 patients with grades 2 and 3 hemorrhoids and minimum to a mild degree of rectal prolapse. The surgical technique is called HeLP.

Methods: Data were collected on the duration of the procedure, intraoperative complications, postoperative pain, the declivity of hemorrhoids, persistency or complete resolution, and recurrence of hemorrhoids were collected prospectively.

Results: No evidence of intraoperative complications occurred. The median follow-up was nine months. Postoperative pain was not significant or null in most patients. There was no rectal tenesmus or alteration of defecation habits. Plateau of hemorrhoid symptoms and downgrading of hemorrhoid size reached approximately three to seven months post-procedure. The frequency of pain, bleeding, pruritus ani, and acute hemorrhoidal syndrome decreased by 75-80%. There was a significant reduction in hemorrhoids with the rate of recurrence being 7% over 12 months of follow-up.

Conclusion: Our study evaluated and demonstrated that HeLP is an effective, safe, and non-painful procedure for the management of patients with the symptomatic second or third degree of hemorrhoid with mild to the minimum degree of rectal mucosal prolapse. It is a suitable ambulatory treatment.

• acute hemorrhoidal syndrome
• hemorrhoidal disease
• laser procedure
• prospectively
• rectal prolapse

• Botox
• Botulinum toxin
• hemorrhoidectomy
• pain

• haemorroidal disease
• haemorroidectomy
• haemorroids
• hemorrhoidal
• hemorrhoids
• history
• surgery
• surgical therapies

• hemorrhoidectomy
• surgical procedure
• ultrasonic scalpel

• Efficacy
• Hemorrhoids
• Postoperative complications
• Ruiyun procedure for hemorrhoids
• Safety
• Simplified Milligan–Morgan hemorrhoidectomy

• HAL
• Hemorrhoidal disease
• Mucopexy
• RAR
• Treatment

• Delayed post-hemorrhoidectomy bleeding
• Hemorrhoidectomy
• Risk factors
• Semi-closed hemorrhoidectomy

• Complications
• Hemorrhoids
• Laser
• Outcomes

• Female
• Hemorrhoidectomy/adverse effects
• Hemorrhoids/complications
• Hemorrhoids/diagnosis
• Hemorrhoids/surgery
• Humans
• Laser Therapy/adverse effects
• Male
• Middle Aged
• Pain, Postoperative/etiology
• Perioperative Care
• Quality of Life
• Recurrence
• Reoperation
• Treatment Outcome

• University of Geneva

• Help
• Hemorrhoid laser procedure
• Minimal invasive procedure
• Patient Global Improvement Scale

Hemorrhoidal prolapse is a common benign disease with a high incidence. The treatment procedure for prolapse and hemorrhoids (PPH) remains an operative method used for internal hemorrhoid prolapse. Although it is related to less pos-operative pain, faster recovery and shorter hospital stays, the postoperative recurrence rate is higher than that of the Milligan-Morgan hemorrhoidectomy (MMH). We have considered that recurrence could be due to shortage of the pulling-up effect. This issue may be overcome by using lower purse-string sutures [modified-PPH (M-PPH)].

To compare the therapeutic effects and the patients’ satisfaction after M-PPH, PPH and MMH.

This retrospective cohort study included 1163 patients (M-PPH, 461; original PPH, 321; MMH, 381) with severe hemorrhoids (stage III/IV) who were admitted to The 2^nd Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University from 2012 to 2014. Early postoperative complications, efficacy, postoperative anal dysfunction and patient satisfaction were compared among the three groups. Established criteria were used to assess short- and long-term postoperative complications. A visual analog scale was used to evaluate postoperative pain. Follow-up was conducted 5 years postoperatively.

Length of hospital stay and operating time were significantly longer in the MMH group (8.05 ± 2.50 d, 19.98 ± 4.21 min; P < 0.0001) than in other groups. The incidence of postoperative anastomotic bleeding was significantly lower after M-PPH than after PPH or MMH (1.9%, 5.1% and 3.7%; n = 9, 16 and 14; respectively). There was a significantly higher rate of sensation of rectal tenesmus after M-PPH than after MMH or PPH (15%, 8% and 10%; n = 69, 30 and 32; respectively). There was a significantly lower rate of recurrence after M-PPH than after PPH (8.7% and 18.8%, n = 40 and 61; P < 0.0001). The incidence of postoperative anal incontinence differed significantly only between the MMH and M-PPH groups (1.3% and 4.3%, n = 5 and 20; P = 0.04). Patient satisfaction was significantly greater after M-PPH than after other surgeries.

M-PPH has many advantages for severe hemorrhoids (Goligher stage III/IV), with a low rate of anastomotic bleeding and recurrence and a very high rate of patient satisfaction.

• Hemorrhoids
• Milligan-Morgan hemorrhoidectomy
• Postoperative complications
• Procedure for prolapse and hemorrhoids
• Recurrence
• Patient satisfaction

• Hemorrhoids
• Morbidity
• Radiofrequency
• Re-admission

• Haemorrhoids
• Mucopexy
• THD
• Transanal haemorrhoidal dearterialisation

Stapled hemorrhoidopexy has a few advantages such as less postoperative pain and faster recovery compared with conventional hemorrhoidectomy. There are two major devices used for stapled hemorrhoidopexy, PPH stapler (Ethicon EndoSurgery) and DST stapler (Covidien). This study was conducted to investigate the postoperative outcomes among patients with grade III and IV hemorrhoids who underwent hemorrhoidopexy with either of these two devices. A total of 242 consecutive patients underwent stapled hemorrhoidopexy with either PPH stapler (110 patients) or DST stapler (132 patients) at a single center in 2017. We performed a retrospective case–control study to compare the short-term postoperative outcomes and the complications between these two groups. After matching the cases in terms of age, gender, and the grade of hemorrhoids, there were 100 patients in each group (PPH versus DST). There were no significant differences in the postoperative visual analog scale (VAS) score and analgesic usage. Among complications, the incidence of anorectal stricture was significantly higher in the DST group (p = 0.02). Evaluation of the mucosal specimen showed that the total surface area, the muscle/mucosa ratio and the surface area of the muscle were also significantly higher in the DST group (p = 0.03). Further analysis of the DST group demonstrated that patients with anorectal stricture after surgery are younger than patients without anorectal stricture, and higher muscle/mucosa ratio (p = 0.03) and a higher surface area of the muscle (p = 0.03) also measured in the surgical specimen. The two devices provide similar outcomes of postoperative recovery. Patients who underwent DST stapled hemorrhoidopexy had a higher incidence rate of stricture, larger area of muscle excision, and higher muscle/mucosa ratio in the surgical specimen. Further investigation is warranted for a better understanding of the correlation between muscle excision and anorectal stricture.

• Baclofen
• Hemorrhoidectomy
• Postoperative pain

• Hemorrhoidal disease
• Laser hemorrhoidoplasty
• Postoperative discomfort
• Postoperative pain

• Doppler
• Hemorrhoids
• Laser procedure

• Acetaminophen/therapeutic use
• Administration, Topical
• Adult
• Aged
• Analgesics, Opioid/therapeutic use
• Atorvastatin/administration & dosage
• Atorvastatin/therapeutic use
• Defecation
• Double-Blind Method
• Female
• Gels
• Hemorrhoidectomy/adverse effects
• Hemorrhoids/surgery
• Humans
• Hydroxymethylglutaryl-CoA Reductase Inhibitors/administration & dosage
• Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use
• Male
• Meperidine/therapeutic use
• Middle Aged
• Pain Measurement
• Pain, Postoperative/drug therapy
• Prospective Studies
• Wound Healing/drug effects
• Young Adult