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James H. MacLeod, MD

Arch Surg. 1983;118(1):29-32.

Abstract
• In a series of 600 patients suffering from hemorrhoidal symptoms, 709 treatment procedures were performed. Only 7% of the patients required hemorrhoidectomy. In the remaining patients, symptoms were relieved by conservative therapy comprising sclerotherapy, band ligation, or cryotherapy of the internal hemorrhoids only. On the basis of this series, the following proposals are made: (1) the concept of hemorrhoidal destruction should be replaced by one of fibrosis, (2) only the internal hemorrhoids need be treated, (3) hemorrhoids need not be treated unless they produce symptoms and then only the symptoms need be treated, (4) only those far-advanced hemorrhoids in which there has been extensive fragmentation of the supportive connective tissue need be treated surgically, and (5) treatment may be chosen according to the stage of the hemorrhoids.

(Arch Surg 1983;118:29-32)

Author Affiliations
Dr MacLeod is in private practice in Whittier and Alhambra, Calif.

Footnotes
Accepted for publication June 7, 1982.

Read before the annual meeting of the Southern California Chapter of the American College of Surgeons, Newport Beach, Calif, Jan 24, 1982.

Reprint requests to 6721 Painter Ave, Whittier, CA 90601 (Dr MacLeod).

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