Summary: The cases of 400 patients who underwent closed hemorrhoidectomy for hemorrhoidal disease in the so-called "acute stage" over a period of five years have been evaluated. The results were excellent and were almost identical to those in patients undergoing elective procedures. It is emphasized, in agreement with other authors,4, 6-8 that there is no reason why any patient of average risk should not be offered hemorrhoidectomy for hemorrhoidal disease in the acute stage no matter how many quadrants are involved, nor is it necessary to do a radical procedure, since the technic is easily adaptable to almost any situation whether or not there is edema. Four-quadrant hemorrhoidectomies should be avoided because of a higher incidence of anal stenosis. Since it is difficult to determine accurately when hemorrhoids are actually acute, "urgent hemorrhoidectomy" may be a more descriptive phrase.
(C) The ASCRS 1973