Indirect coagulation of residual lesions of circumferential piles after excisional hemorrhoidectomy; a prospective controlled pilot study

Background: “ Circumferential prolapsed piles” poses great challenge for colorectal surgeons. “Infrared photocoagulation” (IFC) is a safe procedure for early stages of piles but is not readily available due to high costs. We introduce a simple simulation of (IFC) for management of residual daughter piles after surgical excision of the main piles. Method 10 patients with circumferential grade III-IV piles were recruited for “indirect cauterization” of residual daughter piles after open excision of the main piles and were observed for one month for postoperative complications. The results were compared to those of the last 10 correlated patients in the database managed by simple excision of the main piles only. Results Three cases of SSI (Surgical Site Infection) with minimal, temporary spotting after removal of dressing were found in the study group. No case of incontinence was recorded Conclusion The “indirect cauterization” technique is feasible with satisfactory outcome for cases of circumferential piles in low resource areas.