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Robin R van Tol, Marieke P A Bruijnen, Jarno Melenhorst, Sander M J van Kuijk, Laurents P S Stassen, Stéphanie O Breukink
PURPOSE: In this study, we describe current practices in the management of hemorrhoidal disease in the Netherlands. METHODS: A validated online survey was performed among Dutch surgeons and residents treating hemorrhoidal disease. Contact details were retrieved from the Dutch Association for Surgery resulting in 619 contacts. Only doctors who were treating hemorrhoidal disease regularly were asked to complete the questionnaire. The following items were assessed: initial treatment, recurrence, complications, and follow-up...
March 15, 2018: International Journal of Colorectal Disease
Gabriele Bellio, Arianna Pasquali, Michele Schiano di Visconte
BACKGROUND: Despite the advantages of stapled hemorrhoidopexy reported in the literature in terms of postoperative pain, hospital stay, and duration of convalescence, it was described to have a higher recurrence rate compared with conventional hemorrhoidectomy. OBJECTIVE: The aim of this study was to evaluate clinical outcomes and patient satisfaction after stapled hemorrhoidopexy at 10-year follow-up. DESIGN: This was a retrospective cohort analysis conducted on prospectively collected data...
April 2018: Diseases of the Colon and Rectum
Sami Asfar
BACKGROUND: Post-hemorrhoidectomy anal stenosis though rare is very disturbing and devastating complication. Many surgical procedures have been described, but despite good results, many complications can ensue like flap necrosis, mucosal ectropion, and restenosis. OBJECTIVE: We report a new simple technique for repair of severe/moderate anal stenosis which requires no extensive flap mobilization or many sutures. PATIENTS AND INTERVENTIONS: This is a personal series of 65 patients treated over a period of 20 years...
March 5, 2018: World Journal of Surgery
Timothy Mott, Kelly Latimer, Chad Edwards
Many Americans between 45 and 65 years of age experience hemorrhoids. Hemorrhoidal size, thrombosis, and location (i.e., proximal or distal to the dentate line) determine the extent of pain or discomfort. The history and physical examination must assess for risk factors and clinical signs indicating more concerning disease processes. Internal hemorrhoids are traditionally graded from I to IV based on the extent of prolapse. Other factors such as degree of discomfort, bleeding, comorbidities, and patient preference should help determine the order in which treatments are pursued...
February 1, 2018: American Family Physician
Mohammad Reza Nikshoar, Zahra Maleki, Behzad Nemati Honar
Introduction: Infrared photocoagulation (IRC) was introduced as a mainstay procedure for treatment of hemorrhoids. The present study aimed to compare the clinical efficacy of IRC compared to closed hemorrhoidectomy. Methods: Forty patients suffering grade-3 hemorrhoid that referred to the surgery clinic at Imam Hossein hospital in Tehran in 2013 were randomly assigned to groups treated with the IRC modality or Ferguson's closed hemorrhoidectomy method. The patients in the 2 groups were followed-up for the first 24 hours after surgery and 8 weeks later...
2018: Journal of Lasers in Medical Sciences
Mustafa Celalettin Haksal, Ali Çiftci, Çağrı Tiryaki, Murat Burç Yazıcıoğlu, Mehmet Özyıldız, Selim Yiğit Yıldız
Objective: The aim of this study was to compare the clinical results of LigaSure-assisted hemorrhoidectomy and Milligan-Morgan hemorrhoidectomy as a conventional method in our clinic. Materials and Methods: Patients who underwent LigaSure-assisted hemorrhoidectomy or conventional hemorrhoidectomy for grade 3 and 4 hemorrhoids in our clinic between 2009 and 2014 were included in this study. The patient data were reviewed by screening records. Gender, age, preoperative hemoglobin and hematocrit levels, operation time, presence of thrombosis, number of packages, hospitalization time, early and late postoperative complications, prolonged pain presence, and follow-up period were recorded...
2017: Turkish Journal of Surgery
Sedigheh Nadri, Hormoz Mahmoudvand, Shirin Rokrok, Mohammad Javad Tarrahi
OBJECTIVE: Hemorrhoidectomy is one of the most common hemorrhoid surgery. Many areas are innervated by nerves, and this makes the surgery to be very painful. Various anesthetic methods have been proposed, and the number of investigations and procedures demonstrated the absence of a reliable method for reducing pain. This study compares the cavity ischiorectal block with spinal anesthesia in reducing postoperative pain, analgesic consumption, and hospital stay. RESEARCH DESIGN: This study is a randomized control trial carried out on seventy patients sampled...
November 27, 2017: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
Danny O Jacobs
PURPOSE OF REVIEW: Efforts continue to improve the treatment of patients with symptomatic hemorrhoidal disease by interventions designed to improve efficiency and effectiveness, including by reducing intraoperative and postoperative pain, decreasing operating times, minimizing blood loss and controlling symptoms and recurrence rates. Simultaneously, there are also renewed efforts to minimize the number of patients who will require procedural intervention by focusing on conservative measures that encourage better bowel regulation and habits...
January 2018: Current Opinion in Gastroenterology
Menelaos Zoulamoglou, Ioannis Kaklamanos, Maria Zarokosta, Ioannis Flessas, Vasileios Bonatsos, Theodoros Piperos, Panagiotis Theodoropoulos, Georgia Barla, Ioanna Stathopoulou, Theodoros Mariolis-Sapsakos
Hemorrhoids are a common anal disorder which affects both men and women of all ages. One out of ten patients with hemorrhoidal disease, requires surgical treatment. Unfortunately though, hemorrhoidectomy is closely related to complications that can be present early or late postoperatively. In the present manuscript, the safe surgical technique which emphasizes to the identification of the key anatomical structure of the ligament of Parks (Trietz's muscle) is adequately described. A total of 200 patients with grades III and IV hemorrhoids, underwent Milligan-Morgan or Ferguson's hemorrhoidectomy...
December 2017: Annals of Medicine and Surgery
Claudio Elbetti, Iacopo Giani, Eugenio Novelli, Jacopo Martellucci, Francesco Feroci
AIM: Aim of the present paper was to evaluate the role of tailored different single pile treatment in the clinical outcome of hemorrhoids. MATERIAL OF STUDY: The surgical strategy considered to treat only pathological piles with different procedure according to each pathological Goligher's degree, presence of fibrous, inelastic redundant internal pile(F) and presence of external pathological pile (external pile congestion or subversion of dental line (E) and skin tag not tolerated from the patient (S))...
2017: Annali Italiani di Chirurgia
Shaivi A Patel, Robert J Kucejko, Edward A Fazendin, Juan L Poggio
BACKGROUND: With increased survival among patients with human immunodeficiency virus (HIV), surgeons have been seeing more cases of anal dysplasia and cancer. There is, however, no data on the incidence of surgical site infections (SSIs) in HIV-positive patients undergoing elective anorectal procedures, nor on the administration of prophylactic antibiotic agents. We reviewed a HIV-positive population that has undergone elective anorectal biopsy of areas of dysplasia observed on office anoscopy to assess the need for antibiotic prophylaxis...
October 13, 2017: Surgical Infections
Yoshiro Iida, Hideo Saito, Yoshihiro Takashima, Kenichiro Saitou, Yoshinori Munemoto
PURPOSE: The procedure for prolapse and hemorrhoids (PPH) has the advantage of less postoperative pain. However, serious postoperative complications have been reported after PPH, and the postoperative recurrence rate is high in comparison with conventional Milligan-Morgan hemorrhoidectomy (MMH). The purpose of this study was to evaluate PPH with low rectal anastomosis (PPH-LA) in comparison with the original PPH and MMH. METHODS: Among a total of 1315 patients with hemorrhoids, MMH was conducted in 322, original PPH using a PPH 01 stapler (PPH01) in 63, PPH-LA using 01 (PPH-LA01) in 236, 03 (PPH-LA03) in 649, and sclerotherapy (SCL) in 45...
December 2017: International Journal of Colorectal Disease
Kenan Erzurumlu, Kağan Karabulut, Gökhan Selçuk Özbalcı, İsmail Alper Tarım, Gökhan Lap, Bülent Güngör
OBJECTIVE: Hemorrhoidal disease is a very common entity in the general population; however, the therapeutic approaches to hemorrhoids remain controversial. The choice of treatment method depends on the grade of the hemorrhoid as well as the experience of the surgeon. The Whitehead hemorrhoidectomy procedure is often applied for grade IV hemorrhoids. MATERIAL AND METHODS: We studied 49 patients who underwent surgery between December 1982 and January 2013. The indications for the Whitehead procedure in all patients were grade IV hemorrhoidal disease...
2017: Turkish Journal of Surgery
A L H Leung, T P P Cheung, K Tung, Y P Tsang, H Cheung, C W Lau, C N Tang
BACKGROUND: Tissue-selecting technique (TST) is a novel stapled hemorrhoidectomy technique which targets the hemorrhoids, leaving uninvolved mucosal bridges intact and avoiding circumferential circular stapling. The aim of this study was to compare the short-term outcomes of TST and transanal hemorrhoidal dearterialization (THD). METHODS: Patients presenting with symptomatic hemorrhoids were recruited. Patients were randomized into two groups: (1) TST and (2) THD...
September 2017: Techniques in Coloproctology
Yong-Heng He, Zhi-Jun Tang, Xiang-Tong Xu, De-Quan Huang, Li-Shun Zhang, Qing-Zhu Tang, Zhi-Min Fan, Xian-Jun Zou, Guo-Jun Zou, Chong-Yang Zhang, Fan Hu, Biao Xie, Yan-Hua Li, Yao Tong, Hong-Chang Liu, Ke Li, Yu-Lian Luo, Fei Liu, Guang-Wei Situ, Zuo-Long Liu
PURPOSE: To explore the safety and efficacy of Ruiyun procedure for hemorrhoids (RPH) or RPH with the simplified Milligan-Morgan hemorrhoidectomy (sMMH) in the treatment of mixed hemorrhoids. METHODS: This is a randomized, controlled, balanced, multicenter study of 3000 patients with mixed hemorrhoids. The outcomes and postoperative complications were compared between 5 types of surgeries. RESULTS: The efficacy rate was the highest in patients who received RPH+sMMH and decreased in the following order: patients who received RPH alone, MMH alone, procedure for prolapse and hemorrhoids (PPH) alone, and PPH+sMMH ( P < ...
September 1, 2017: Surgical Innovation
A Tsunoda, T Takahashi, H Kusanagi
BACKGROUND: The aim of the present study was to compare short- and medium-term results of transanal Doppler-guided hemorrhoidal dearterialization with mucopexy (DM) versus hemorrhoidectomy using an ultrasonic scalpel (US) for third-degree hemorrhoids. METHODS: Forty-four patients were randomly assigned to undergo either DM or US. The patients were followed up at 1, 2, 3 months at our clinic, and by telephone interview when the study was completed in May 2017. The primary endpoint was postoperative pain with quality of life, length of stay, return to normal activities, and incontinence among secondary endpoints...
August 2017: Techniques in Coloproctology
Joshua Tessier, Callie Waller
A 34-year-old Eritrean man presented to the emergency department with complaints of diffuse abdominal pain and distention. He had emigrated to the United States 3 months earlier, following 5 years in a refugee camp in Ethiopia. Two weeks earlier, the patient sought care at his primary care clinic and was diagnosed with post-operative urinary retention and constipation following a recent hemorrhoidectomy. A Foley catheter was inserted and provided a short period of relief. Following the visit, however, his abdominal pain worsened...
September 2017: Journal of Family Practice
Seung Ju Kim, Kyu-Tae Han, Woorim Kim, Sun Jung Kim, Eun-Cheol Park
OBJECTIVE: To explore the impact of mandatory adoption of diagnosis-related groups (DRGs) on the use of outpatient care in Korea. DATA SOURCES: National Health Claim data from 2,022 hospitals and 1,029,101 admission cases during 2011-2014: tonsillectomy/adenoidectomy, inguinal/femoral hernia operation, and hemorrhoidectomy. STUDY DESIGN: Outcome variables included probability of outpatient visit, number of outpatient visits, and outpatient medical expenditures within 30 days...
August 14, 2017: Health Services Research
Domenico Tuscano, Linda D'Amore, Fabio Gaj, Paolo Bruzzone, Elena Annesi, Daniele Ceccarelli, Paolo Negro, Maria Romana Grimaldi, Francesco Gossetti
AIM: Aim of the present study is to propose a clinic-therapeutic course for the treatment of hemorrhoidal disease able to combine radical anatomic surgery with a painless postoperative path. MATERIAL OF STUDY: The present study is based on the evaluation of 20 selected patients who underwent radical hemorrhoidectomy for very high grade hemorrhoidal disease. The clinical course was characterized by careful bowel cleansing, hemorrhoidectomy according to Milligan-Morgan using LigaSure, intraoperative perianal infiltration of Ropivacaine and postoperative use of analgesic drugs...
2017: Annali Italiani di Chirurgia
Yan-Jiun Huang, Chien-Yu Chen, Ray-Jade Chen, Yi-No Kang, Po-Li Wei
BACKGROUND: Hemorrhoidectomy is commonly associated with postoperative pain. Calcium channel blockers are known to cause relaxation of gastrointestinal smooth muscle and oral diltiazem has also been shown to reduce the resting anal pressure. OBJECTIVE: We attempted to analyze efficacy and side effects of topical diltiazem oint. in post-operative pain control. METHODS: This is a meta-analysis of patients who underwent hemorrhoidectomy using topical diltiazem oint...
July 8, 2017: Asian Journal of Surgery
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