The general principles of treatment: (1) Do not treat asymptomatic hemorrhoids; (2) The treatment should focus on reducing or eliminating the main symptoms, rather than radical surgery; (3) Conservative treatment is the mainstay. Only when conservative treatment fails, surgery is considered; (4) According to Different conditions of hemorrhoids, choose different treatment methods.
The principle of treatment in Japan: In 198, Yukio Sumigoe proposed that hemorrhoids should be treated conservatively during stage I, II, and III. Band ligation was used for stage Ⅱ and Ⅲ, and surgery was used for stage Ⅳ.
American principles of treatment: In a symposium on hemorrhoids in 1977, Thomson introduced the general situation of internal hemorrhoids treatment at St. Mark's Hospital in London. Approximately 75% of patients in this hospital are treated with sclerotherapy, 20% are ligated with rubber bands, and the remaining 5% of hemorrhoids are treated with surgery. Surgical method: Milligan ligation resection was used in 85%, and Parka submucosal resection was used in 15%. ①According to the degree of prolapse, hemorrhoids are divided into 4 degrees: degree I—internal hemorrhoids are located in the anal canal; degree II—internal hemorrhoids can protrude outside the anus during defecation, but can be repaid by themselves; degree III—prolapse from the anus in a natural state or during defecation In addition, you need to use your hands to help pay; you can’t pay if you get out of degree IV. ②Most symptomatic hemorrhoids, including thrombotic hemorrhoids and patients with degree I or some internal hemorrhoids of degree II, can be treated with simple treatments in the outpatient clinic. ③ Even advanced hemorrhoids can be treated in outpatient clinics for high-risk patients or elderly patients, avoiding anesthesia and surgery. ④Conservative treatment failed, patients with severe symptoms, severe thrombosis, and third or fourth degree internal hemorrhoids require surgical treatment. If there are complications, especially anal stenosis, anal fistula, surgical treatment is needed as soon as possible.
German treatment principles: The treatment principles formulated at the 9th Colorectal Surgery Conference in Cologne, Germany in 1984 are as follows: ①Do not use corticosteroid-containing anal suppositories and ointments for a long time to avoid irritating the perianal skin and causing irreversible damage ②Sclerotherapy injection is the first choice for hemorrhoids in stage I. ③The first choice for hemorrhoids in stage II is a rubber band ligation, and injection therapy is also available for smaller stage II hemorrhoids.
④In the third stage, hemorrhoids must be hospitalized for surgical treatment. All hemorrhoidectomy operations have the possibility of fatal bleeding and must be vigilant.