대한대장항문학회

Purpose : A modified technique of pile suture (PS) was introduced with its principle and<br>useful indications. Methods : A transfixing suture was layed onto the base of hemorrhoidal<br>cushion including vessels, submocosal connective tissues, and internal anal sphincter.<br>According to morphological changes in the pile, several (0∼2) sutures were added downward<br>upto the level of the dentate line. We have treated 348 patients with third and fourth degree<br>hemorrhoids by either this technique alone (28 patients) or by combination with other<br>techniques (320 patients). The median follow-up period was 39 months. Results : This<br>technique showed earlier convalescence and lesser complications than the open<br>hemorroidectomy (OH) (p＜0.05): PS vs. OH, hospitalization 2.3 vs. 4.7 days; pain, 4.2 vs. 6.9<br>days; discharge, 0 vs. 8.6 days; dripping amount of bleeding, 3.8% vs. 13.9%. There was no<br>recurrence in both operative techniques. Conclusions : Because hemorrhoids present diverse<br>shapes and symptoms, various operative techniques may be more efficient than single<br>technique alone. Pile suture appears to be an useful armamentarium in treating hemorrhoids,<br>especially in cases of recurrent or multiple hemorrhoids.<br>