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Haemorrhoids are a common condition. It can cause a lot of inconvenience to the sufferers. Most patients just endure it in silence with fear of revealing the disease. They don’t see a doctor or only seek doctor’s consultation until later stages in their illness. At that time, surgical treatment is the only way to treat the disease thoroughly.
The decision to use medical treatment or surgery depends on the level of the disease present. Patients with hemorrhoids grade I or II can be given medication or simple procedures. Surgery is normally indicated for those with hemorrhoids grade III and IV.
Along with conventional Milligan-Morgan hemorrhoidectomy, Longo is a Longo procedure was invented in 1996 to treat hemorrhoids and has widely been used in Europe the level of injury and on the stage of the disease.
Longo procedure was invented in 1996 to treat hemorrhoids and it has developed in Europe since then. This technique is performed using an adapted circular stapler (an automatic suturing instrument) to excise a mucosal cylinder and lower the rectual mucous membrane (above the pectinate line), aiming at devascularise the cushions. At the same time the surgeon will reduce the prolapsing anal mucous membrane. The hemorrhoids themselves shrink away because their blood supply is cut off.
As the surgical area is above the pectinate line, less post-operative pain, no anal stenosis or open wound affect to the patient. This is meant to allow the patient to resume work early. However, apart from the procedural cost, the patient shall bare additional cost of single use suturing device.
INTERNAL HEMORRHOIDS CAN BE GRADED AS FOLLOWS:
|
Grade |
Symptoms |
Treatment |
|
Grade I |
Small hemorrhoids may cause bleeding but not prolapsing even when the patient passes stool. |
Treatment of body cream and ointment or suppositories
|
|
Grade II |
Size of internal hemorrhoids is bigger, cause bleeding and protrude when the patient passes stool
|
Medication combined with such procedures as: hemorrhoids ligation, Injection (sclerotherapy), freezing hemorrhoids through the use of liquid nitrogen, coagulation by laser, etc. |
|
Grade III |
Big hemorrhoids that often protrude with benign mucus membrane when the patient passes stool. The sufferer must reduce hemorrhoids manually. |
Surgery |
|
Grade IV |
Symptoms like grade III but the patient can not reduce hemorrhoids by hand. Inflammation, erosion or thrombosis occurs. |
Surgery |
According to visceral surgeons of L’Hôpital Francais de Hanoi , Longo is an effective treatment for hemorrhoids which helps patient have faster recovery. However, it can just be applied to grade III hemorrhoids. On patients with late grade IV hemorrhoids or suffering from its complications, Milligan-Morgan technique should be used.
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