When is excision indicated in the treatment of external hemorrhoids?

Updated: Aug 17, 2018
  • Author: Brett Wallace Lorber, MD, MPH, FACEP; Chief Editor: Erik D Schraga, MD  more...
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Answer

Acute pain and thrombosis of an external hemorrhoid within 48-72 hours of onset is an indication for excision.

In a retrospective study by Greenspon et al, surgical treatment resulted in much faster symptom resolution (3.9 days vs 24 days), as well as a lower frequency of recurrence (6.3% vs 25.4%), in the study population. [13] A study by Cavcić et al demonstrated that in comparison with simple incision or topically applied 0.2% glycerin trinitrate ointment, thrombosed external hemorrhoid excision improved recurrence rates, symptoms, and residual skin tags at 1-year follow-up. [14]


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