[Hemorroidal disease in a specialty medical center].

BACKGROUND DATA: Haemorrhoids and the symptoms they produce have been recorded throughout history. This disease affects 4-10% of the population. The treatment is based on the degree of haemorrhoidal prolapse and the severity of symptoms.

OBJECTIVES: The aim of this study is to show our experience in the treatment of haemorrhoidal disease in the colorectal surgery department from the Centro Médico Nacional Siglo XXI, (IMSS, México, D.F).

METHODS: Clinical files were reviewed of patients treated by surgical procedures in a period from March 1996 to March 2004.

RESULTS: 3,304 medical consultations were given to first time patients; 443 patients were diagnosed with haemorrhoidal disease representing 13.4% of the anorectal pathology: 358 patients underwent an anorectal operation, 225 males (62.8%) and 133females (37.2%), mean age of 48 years (range 18-78 years). The principal symptoms were bleeding and pain. We found another associated pathology in 20% of the cases. 46 patients were affected by second degree haemorrhoids (12.8%), 244 third degree (68.3%) and 68 patients by fourth degree (19%). The Ferguson technique was the most used (84%). At the same time as the haemorrhoidectomy we did other anorrectal procedures in 20% of patients. The mean operation time was 53 minutes (range 19-150). Acute urinary retention occurred in 28 patients (8%) leak sutures in seven (2%), and bleeding in six (1.7%). The mean hospital stays were two days with follow up of 42 days. The total morbility was 4.7%.

CONCLUSIONS: The incidence of haemorrhoidal disease in this study was 13.4%. 80% ofpatients were treated by surgery. This pathology is more common in the fifth decade of life with male-female relation of 1. 7:1. The acute urinary retention was the most common complication. During the performing of a haemorrhoidectomy it was possible to resolve other anorectal pathologies. The Ferguson technique was the most used with a total morbility of 4.7%.