'Bumps Down Under:' Hemorrhoids, Skin Tags and All Things Perianal

Authors and Disclosures

Melissa M. Alvarez-Downing^a and Giovanna da Silva<sup>b

a</sup>Department of Surgery, Division of Colorectal Surgery, Rutgers New Jersey Medical School, Newark, New Jersey and ^bDepartment of Colorectal Surgery, Cleveland Clinic Florida, Weston, Florida, USA

Correspondence to
Giovanna da Silva, MD, FACS, FASCRS, Department of Colorectal Surgery, Cleveland Clinic Florida, 2950 Cleveland Clinic Boulevard, Weston, FL 33331, USA. Tel: +1 954 659 5703; fax: +1 954 659 5252; e-mail: dasilvg@ccf.org

Conflicts of interest
There are no conflicts of interest.

Sidebar

Key Points

• Additional studies are required to delineate the utility of laser and bipolar energy in the treatment of symptomatic internal hemorrhoids.

• In the quest to find a 'painless' treatment for hemorrhoids that progress to require surgery, the implementation of varying techniques has yet to achieve this goal.

• Lateral internal sphincterotomy for the treatment of chronic anal fissure in low-risk patients is still the most effective treatment.

• Modifications to the LIFT procedure with submucosal approach or addition of video-assistance are advancements in technology that warrant further exploration.

• There remains a paucity of prospective data evaluating treatment options for hemorrhoids, anal fissure and anal fistula with long-term follow-up.