Surgical Management of Internal Haemorrhoids in Manizales, 2010 to 2017

Haemorrhoidal disease is the most common proctological pathology, however only 10% require surgical management. This book aims to describe the surgical management of internal haemorrhoids in a referral centre in Manizales between 2010 and 2017. This is a retrospective, descriptive study of a population diagnosed with grade II, III and IV haemorrhoids, who underwent haemorrhoidectomy between 2010 and 2017 at SES Hospital de Caldas in Manizales, with a 12-month follow-up. A total of 809 patients were diagnosed, of whom 93 (11.5%) underwent surgery, 59.1% were men, with an average age of 55.8 years. The main surgical indication was bleeding (38.7%), rectal pain (22.6%) and sensation of mass (15%). The majority corresponded to grade III (36.6%) and grade II (25.8%). The conventional technique was the most commonly performed (69.9%), of which the open Milligan Morgan technique (61.3%), followed by the closed Ferguson technique (8.6%). Of the non-conventional (30.1%), the endoscopic approach for band ligation was used in 20 patients (21.5%), Harmonico scalpel (4.3%) and PPH endograft (4.3%).