Comparing PPH and Endoscopic Treatments for Hemorrhoids: Which is Better? - Surgery

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When it comes to treating hemorrhoids, two popular surgical options are the Procedure for Prolapse and Hemorrhoids (PPH) and endoscopic treatments, such as rubber band ligation. Each method has its own advantages and disadvantages, and the choice between them often depends on the specific circumstances of the patient, including the type and severity of the hemorrhoids, as well as personal preferences regarding recovery and pain management.


PPH (Procedure for Prolapse and Hemorrhoids)
PPH is a relatively newer surgical technique that focuses on treating prolapsed hemorrhoids. This method involves using a circular stapler to remove excess tissue and reposition the hemorrhoids back into their normal position. One of the significant advantages of PPH is that it typically results in less postoperative pain compared to traditional hemorrhoidectomy. Patients often experience a quicker recovery time and may even be able to go home the same day as the surgery. Studies have shown that PPH can lead to a lower incidence of complications such as bleeding and infection, making it an attractive option for many patients.

However, PPH is primarily effective for internal hemorrhoids and may not address external hemorrhoids or mixed hemorrhoids effectively. Additionally, while the procedure is less painful, some patients may still experience discomfort during the recovery period.

Endoscopic Treatments (Rubber Band Ligation)
Endoscopic treatments, particularly rubber band ligation, are less invasive and can be performed in an outpatient setting. This method involves placing a small rubber band around the base of the hemorrhoid, cutting off its blood supply. Over time, the hemorrhoid shrinks and falls off. One of the key benefits of this approach is that it typically involves minimal pain and allows patients to return to their normal activities almost immediately after the procedure.
Rubber band ligation is particularly effective for treating internal hemorrhoids and is often recommended for patients with mild to moderate symptoms. However, it may not be suitable for larger or prolapsed hemorrhoids, and there is a risk of complications such as bleeding or infection, although these are generally rare.


Which is Better?
The choice between PPH and endoscopic treatments largely depends on the individual case. For patients with significant prolapse or larger internal hemorrhoids, PPH may be the better option due to its effectiveness in repositioning and removing excess tissue. On the other hand, for those with smaller internal hemorrhoids or those who prefer a less invasive approach, rubber band ligation may be more appropriate.


Recommendations for Hospitals in Tainan
In Tainan, several hospitals are equipped to perform these procedures. Notable institutions include:
1. National Cheng Kung University Hospital: Known for its advanced surgical techniques and experienced colorectal surgeons.

2. Tainan Municipal Hospital: Offers a range of gastrointestinal services, including hemorrhoid treatments.

3. Chi Mei Medical Center: Provides both PPH and endoscopic treatments with a focus on patient comfort and rapid recovery.


Conclusion
Ultimately, the best course of action should be determined in consultation with a qualified healthcare provider who can assess the specific condition and recommend the most appropriate treatment. Both PPH and endoscopic treatments have their merits, and understanding the differences can help patients make informed decisions about their care. It’s essential to discuss all options, including potential risks and benefits, with a healthcare professional to ensure the best outcome for your individual situation.