For hemorrhoids, the surgical indications should be strictly controlled. Asymptomatic hemorrhoids do not require treatment, and the purpose of treatment of symptomatic hemorrhoids is to eliminate and relieve the main symptoms of hemorrhoids, rather than radical surgery as the first choice. This is because the anal cushion, which is the original source of hemorrhoids, has an important function of sensing and controlling feces, so it is best not to remove it. In addition, there are very rich nerves in the anus, and the pain is very acute. After the operation, the pain will be more severe. In addition, it takes a long time for wounds to heal in the anus, which will bring greater pain to patients, and hemorrhoids will not become cancerous. Therefore, surgical indications should be strictly controlled. Generally speaking, surgical treatment is only suitable for severe Ⅱ, Ⅲ, Ⅳ Internal hemorrhoids, mixed hemorrhoids and non-surgical treatment including thrombosis or hematoma are ineffective. Regardless of the surgical method, the anal cushion should be preserved as much as possible, and attention should be paid to avoid complications such as postoperative bleeding, anal stenosis, and anal insufficiency. At present, the following four conditions are mostly used as surgical indications, namely ① Internal hemorrhoids of degree Ⅲ and Ⅳ; ② Internal hemorrhoids of degree Ⅰ and Ⅱ have a large amount of bleeding and conservative treatment is ineffective; ③ Acute incarcerated hemorrhoids; ④ External hemorrhoids with symptoms and signs .
-----Excerpted from "The Secret of Hemorrhoids" edited by Li Shenglong and Yin Tingbao