HEMORRHOIDAL DISEASE: EVALUATION OF THE EFFECTIVENESS, RECURRENCE, AND COMPLICATIONS OF CLINICAL THERAPY, ELASTIC BAND LIGATION, SCLEROTHERAPY, AND CONVENTIONAL AND STAPLED SURGICAL TECHNIQUES

Abstract

Objective: To evaluate the effectiveness, recurrence rates, and complications of the main therapeutic modalities for hemorrhoidal disease (HD). Methods: An integrative literature review was conducted using the PubMed, SciELO, and BVS databases, covering the period from 2020 to 2026. The search used controlled descriptors (DeCS/MeSH) and resulted in the selection of 58 references for critical analysis. Results: Clinical therapy and outpatient methods (elastic ligation and sclerotherapy) show high efficacy (up to 90%) for grades I and II, although with higher recurrence rates compared to surgery. Conventional hemorrhoidectomy remains the gold standard for grade IV due to the lower recurrence rate (<5% in 10 years), despite intense postoperative pain. Stapled techniques (PPH) and energy technologies reduce immediate discomfort and recovery time, but are associated with higher risks of prolapse recurrence and specific functional complications. Conclusion: There is no universally superior technique; Therapeutic success depends on "surgical tailoring," individualizing the approach according to the stage of the disease, the patient's expectations, and the surgeon's skill in minimizing impacts on anorectal physiology.