BACKGROUND: @entity10700 has never been a popular operation due to its difficulty and duration, the amount of @entity190 , and the risk of @entity322 . The main indication for hemorrhoidectomy according to Parks is fourth-degree @entity6713 with prolapse of the dentate line outside the anus and with simultaneous presence of external @entity6713 . We report our experience in the treatment of @entity6713 using submucosal reconstructive hemorrhoidectomy according to Parks. METHODS: A total of 640 @entity1 (381 @entity1 and 259 @entity1 ) of median age 42 years (range, 18-81) were treated between 1983 and 2002; 80% of @entity1 had fourth-degree, 19% third-degree and 1% second- degree @entity6713 . All @entity1 underwent rectosigmoidoscopic examination before surgery; @entity1 over 35 years of age or with a suspected inflammatory or @entity5 underwent colonoscopy or barium enema. All @entity1 underwent anorectal manometry before operation, to measure anal resting pressure, maximal squeeze and sphincter length, with the purpose of determining if an internal sphincterotomy was also necessary (in case of high anal resting tone). One-third of the @entity1 also had an internal sphincterotomy to correct anal @entity4372 . RESULTS: @entity86 occurred in 19 @entity1 (2.9%), 0.9% requiring a reintervention. Severe @entity158 was reported by 9 @entity1 (1.4%); fecal impaction occurred in 3 cases (0.5%) and suture disruption in 2 @entity1 (0.3%). In 74 @entity1 (11.6%), bladder catheterization was needed due to urinary retention. Of 550 @entity1 who had a minimum follow-up of 3 years and were sent a postal questionnaire, 374 @entity1 responded, with a median 7.3-year follow- up; 176 @entity1 (32%) were lost to follow-up. Eleven @entity1 (2.9% of 374 cases) reported @entity158 during defecation, 6 (1.6%) developed @entity272 or recurrence, 3 (0.8%) reported gas @entity322 , 2 (0.5%) developed @entity9292 and 1 (0.3%) had anal stricture. CONCLUSIONS: @entity10700 according to Parks still represents a good choice for the treatment of high-degree @entity6713 with prolapse of the dentate line outside the anus and external circumferential @entity6713 .

XXXX (Parks' operation): a 20-year experience.

@entity1 :: ('9606', 'Species') :: ['women', 'patients', 'men'] @entity4372 :: ('MESH:D009122', 'Disease') :: ['hypertonia'] @entity322 :: ('MESH:D014549', 'Disease') :: ['incontinence'] @entity190 :: ('MESH:D006473', 'Disease') :: ['blood loss'] @entity5 :: ('MESH:D009369', 'Disease') :: ['neoplastic disease'] @entity272 :: ('MESH:D012871', 'Disease') :: ['skin tags'] @entity9292 :: ('MESH:D012003', 'Disease') :: ['anal fistula'] @entity86 :: ('MESH:D019106', 'Disease') :: ['Postoperative bleeding'] @entity6713 :: ('MESH:D006484', 'Disease') :: ['hemorrhoids'] @entity158 :: ('MESH:D010146', 'Disease') :: ['pain'] @entity10700 :: ('MESH:C563509', 'Disease') :: ['Submucosal reconstructive hemorrhoidectomy']
@entity10700 :: (MESH:C563509,Disease) :: ['Submucosal reconstructive hemorrhoidectomy']
