Em 34.000 pacientes coloproctológicos foi feito o diagnóstico de doença hemorroidária (DH), como doença coloproctológica principal, em 9.289 pacientes (27,3%), dos quais 1.122 (12,1%) eram portadores de doenças anais concomitantes à DH (DAC). Dos 9.289 portadores de DH, 2.417 foram operados de DH (26,0%) e destes, 729 foram operados, ao mesmo tempo, de DAC (30,2%). Assim, dos 1.122 portadores de DAC, 729 foram operados delas (65,0%). Em relação aos 9.289 portadores de DH, a DAC mais comum foi a fissura anal (541 casos, 5,8%), seguida de hipertrofia de papilas anais (312 casos, 3,4%), fístulas anais (117 casos, 1,3%), hipotonia anal com incontinência parcial (112 casos, 1,2%), condilomas anais acuminados (37 casos, 0,4%) e tumores anais (3 casos, 0,03%); e a mesma ordem foi verificada em relação às 1.122 DAC: fissura anal (48,2%), hipertrofia de papilas anais (27,8%), fístulas anais (10,4%), hipotonia anal com incontinência parcial (10,0%), condilomas anais acuminados (3,3%) e tumores anais (0,3%). Em relação à cirurgia, das 1.122 DAC 729 foram operadas (65,0%) nesta ordem: fissura anal (317 casos, 28,3%), hipertrofia de papilas anais (267 casos, 23,8%), fístulas anais (89 casos, 7,9%), hipotonia anal com incontinência parcial (31 casos, 2,8%), condilomas anais acuminados (22 casos, 1,9%) e tumores anais (3 casos 0,3%); e em relação às próprias DAC as incidências de cirurgias foram: tumor anal (100,0%), hipertrofia de papilas anais (85,6%), fístulas anais (76,0%), condilomas anais acuminados (59,6%), fissuras anais (58,6%) e hipotonia com incontinência anal parcial (25,8%). A confirmação dos diagnósticos das DAC pelo exame histopatológico foi de 72,8%, em ordem decrescente: condilomas anais e fístulas anais (100,0%), hipertrofia de papilas anais (79,0%), fissuras anais (68,5%) e tumores anais (66,7%).
In a 38-year period of practice in Coloproctology, the author had the opportunity to attend 34,000 patients and the diagnosis of hemorrhoid as the main cause of the symptoms presented was achieved in 9,289 patients (27.3%) being hemorrhoid associated with several anorectal diseases in 1,122 patients (12.1%). 2,417 patients of the patients underwent hemorrhoidectomy (26.0%) and 729 of theese patients were operated on for associated anal diseases at the same time (65.0%). The most frequently diagnosed associated anal diseases were anal fissures (541 cases, 5.8%) and hyperthrofied anal papila (312 cases, 3.4%) folowed by anal fistulae (117 cases, 1.3%), partial fecal incontinence (112 cases, 1.2%), anal condyloma (37 cases, 0,4%) and anal tumors (3 cases, 0,03%). The same order of incidence was verified in relation to the 1,122 cases of associated anal diseases: anal fissures (48.2%), hyperthrofied anal papila (27.8%), anal fistulae (10.4%), partial fecal incontinence (10.0%), anal condyloma (3.3%) and anal tumors (0,3%). As far as associated anal diseases are concerned (1,122 cases), the incidence of surgery was 65.5% (729 patients) in this order: fissurectomy (317 cases, 28.3%), anal papilectomy (267 cases, 23.8%), anal fistulectomy (89 cases, 7.9%), partial fecal incontinence (31 cases, 2.8%), resection of anal condylomata (22 cases, 1.9%), resection of anal tumors (3 cases, 0.3%). And as far as each associated anal disease is concerned the incidence of surgery was the following: resection of anal tumors (100,0%), papilectomy (85.6%), fistulectomy (76.0%), resection of anal condylomata (59.6%), fissurectomy (58.6%) and partial fecal incontinence (25.8%). Associated anal diseases with the highest proportion of confirmation of proctologic diagnosis by the histopathologic examination were anal fistula (100.0% of 89 operated patients), anal condyloma (100.0% of 22 operated patients), hyperthrophied anal papilla (79.0% - 211 - of 267 operated patients), anal fissure (68.5% - 217 - of 317 operated patients) and anal cancer (66.7% - 2 of 3 operated patients).