FOCUS ON – Consensus statement SICCR – Hemorrhoids (commented by Mario Pescatori)

Evaluation and management of hemorrhoids: Italian Society of Colorectal Surgery (SICCR) consensus statement
Trompetto M, Clerico G, Cocorullo GF, Giordano P, Marino F, Martellucci J, Milito G, Mistrangelo M, Ratto C.
Tech Coloproctol. 2015 Oct;19(10):567-75. doi: 10.1007/s10151-015-1371-9. Epub 2015 Sep 24. PMID: 26403234

Considering my role, i.e co-founder, Honorary President and Editor-in-chief of the official journal Techniques in Coloproctology, let me say that I am proud of the SICCR. This is the only society which published more than five GUIDELINES in two years. The article on hemorrhoids is a good combination of suggestions on three surgical procedures. The PPH, declining due to cost, complications and recurrences, but still useful in very selected cases. The THD with or without mucopexy, a mushrooming less invasive operation, to be carried out in non advanced piles, and the manual closed or open hemorrhoidectomy, still the “goldstandard”, at least in case of 4th degree internal and significant external piles. The latest one may be performed with the LigaSure. According to the Ucp-Club SICCR annual report, this is the most used operation for hemorrhoids among the society members working in affiliated Coloproctology Unit. Probably due to the low number of published reports, the authors did not mention another costless and effective mini-invasive procedure, the ligation-anopexy (Hussein in Dis Coo Rectum 2001 and Tech Coloproctol 2015).