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hemorrhoidectomy

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https://www.readbyqxmd.com/read/28589634/systematic-review-and-meta-analysis-of-the-role-of-metronidazole-in-post-haemorrhoidectomy-pain-relief
#1
REVIEW
Njr Lyons, J B Cornille, S Pathak, P Charters, I R Daniels, N J Smart
AIM: Conventional haemorrhoidectomy is still considered as the reference standard for the management of severe or recurrent haemorrhoids. Pain is reported by patients to be the most common post operative complication. Although the literature lacks a consensus on its effectiveness, Metronidazole is often used to reduce post operative pain.. We have performed a meta-analysis of all randomised controlled trials (RCTs) that investigated the use of metronidazole for pain relief after haemorrhoidectomy...
June 7, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28562733/randomized-clinical-study-on-the-analgesic-effect-of-local-infiltration-versus-spinal-block-for-hemorrhoidectomy
#2
Luis Antônio Borges, Plínio da Cunha Leal, Ed Carlos Rey Moura, Rioko Kimiko Sakata
BACKGROUND AND OBJECTIVES: Postoperative analgesia and early recovery are important for hospital discharge. The primary objective of this study was to compare the analgesic effectiveness of perianal infiltration and subarachnoid anesthesia for hemorrhoidectomy. The secondary objective was to compare time to discharge, adverse effects and complications. DESIGN AND SETTING: Randomized, prospective and comparative study at Dr. Mário Gatti Hospital. METHODS: Forty patients aged 18-60, in American Society of Anesthesiologists physical status category 1 or 2, were included...
May 29, 2017: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/28514383/-efficiency-of-combined-methods-of-hemorroid-treatment-using-hal-rar-and-laser-destruction
#3
G V Rodoman, L V Kornev, T I Shalaeva, R N Malushenko
AIM: To develop the combined method of treatment of hemorrhoids with arterial ligation under Doppler control and laser destruction of internal and external hemorrhoids. MATERIAL AND METHODS: The study included 100 patients with chronic hemorrhoids stage II and III. Combined method of HAL-laser was used in study group, HAL RAR-technique in control group 1 and closed hemorrhoidectomy with linear stapler in control group 2. Сomparative evaluation of results in both groups was performed...
2017: Khirurgiia
https://www.readbyqxmd.com/read/28451767/distal-doppler-guided-transanal-hemorrhoidal-dearterialization-with-mucopexy-versus-conventional-hemorrhoidectomy-for-grade-iii-and-iv-hemorrhoids-postoperative-morbidity-and-long-term-outcomes
#4
L Trenti, S Biondo, A Galvez, A Bravo, J Cabrera, E Kreisler
BACKGROUND: Distal Doppler-guided transanal hemorrhoidal dearterialization with mucopexy (Doppler-guided THD) seems to be associated with better short-term outcomes than conventional hemorrhoidectomy, but there are little data about long-term recurrence. The aim of this study was to compare Doppler-guided THD for grade III-IV hemorrhoids with conventional hemorrhoidectomy with regard to long-term postoperative morbidity and recurrence. METHODS: This was a single-center longitudinal and comparative study of a cohort of patients who underwent either distal Doppler-guided THD with low ligation of the hemorrhoidal artery and mucopexy or conventional excisional hemorrhoidectomy (Milligan and Morgan or Ferguson) for grade III and IV hemorrhoids...
April 27, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28432678/anal-metastasis-of-rectal-cancer-adenocarcinoma-of-squamous-cells-a-case-report-and-literature-review
#5
Shun Sasaki, Masahiko Sugiyama, Yu Nakaji, Ryota Nakanishi, Yuichiro Nakashima, Hiroshi Saeki, Eiji Oki, Yoshinao Oda, Yoshihiko Maehara
Anal metastasis of colorectal cancer is very rare and is usually associated with a history of anal disease, including anal fistula, fissure, hemorrhoidectomy, and anastomotic injury. We report a case of rectal cancer with a synchronous anal metastasis consisting of adenocarcinoma of squamous cells without a history of anal disease. A 60-year-old woman had a chief complaint of melena. She had a 1.5-cm anal tumor on the perianal skin, and a Bollman type 2 rectal tumor on the Ra portion was found on colonoscopy...
December 2017: Surgical Case Reports
https://www.readbyqxmd.com/read/28403427/new-persistent-opioid-use-after-minor-and-major-surgical-procedures-in-us-adults
#6
Chad M Brummett, Jennifer F Waljee, Jenna Goesling, Stephanie Moser, Paul Lin, Michael J Englesbe, Amy S B Bohnert, Sachin Kheterpal, Brahmajee K Nallamothu
Importance: Despite increased focus on reducing opioid prescribing for long-term pain, little is known regarding the incidence and risk factors for persistent opioid use after surgery. Objective: To determine the incidence of new persistent opioid use after minor and major surgical procedures. Design, Setting, and Participants: Using a nationwide insurance claims data set from 2013 to 2014, we identified US adults aged 18 to 64 years without opioid use in the year prior to surgery (ie, no opioid prescription fulfillments from 12 months to 1 month prior to the procedure)...
April 12, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28398580/how-did-market-competition-affect-outpatient-utilization-under-the-diagnosis-related-group-based-payment-system
#7
Seung Ju Kim, Eun-Cheol Park, Sun Jung Kim, Kyu-Tae Han, Sung-In Jang
Objective: Although competition is known to affect quality of care, less is known about the effects of competition on outpatient health service utilization under the diagnosis-related group payment system. This study aimed to evaluate these effects and assess differences before and after hospitalization in South Korea. Design: Population-based retrospective observational study. Setting: We used two data set including outpatient data and hospitalization data from National Health Claim data from 2011 to 2014...
April 7, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28367179/comparison-of-two-procedures-for-symptomatic-hemorrhoidal-disease-ligation-under-vision-and-ferguson-hemorrhoidectomy-a-retrospective-cohort-study
#8
Hakan Demir, Kerem Karaman, Metin Ercan, Havva Belma Kocer, Fehmi Celebi
OBJECTIVE: To compare Ligation under Vision (LUV) with Ferguson Hemorrhoidectomy (FH) in patients with Grade II, III and IV hemorrhoidal diseases according to their postoperative outcomes. METHODS: Between July 2008 and August 2014, 155 patients underwent FH and 120 patients LUV, in Sakarya University Teaching and Research Hospital. Our retrospective analysis focuses on postoperative complications, postoperative pain and rate of recurrence. In LUV procedure, submucosal tissue of the hemorrhoidal pile base was transfixed using absorbable sutures under direct vision through anoscope in the Jackknife position...
January 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28267013/systemic-metronidazole-may-not-reduce-posthemorrhoidectomy-pain-a-meta-analysis-of-randomized-controlled-trials
#9
Kerollos Nashat Wanis, Heather M Emmerton-Coughlin, Shaun Coughlin, Norine Foley, Christopher Vinden
BACKGROUND: Hemorrhoidectomy is associated with significant postoperative pain. Oral metronidazole has been recommended as an adjunct to improve posthemorrhoidectomy analgesia. OBJECTIVE: This study aimed to evaluate the impact of oral metronidazole on patient-reported pain following hemorrhoidectomy. DATA SOURCES: We conducted a systematic search in the MEDLINE, EMBASE, ISI Web of Science, and Cochrane Central Register of Controlled Trials databases...
April 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28256813/intraspinal-administration-of-morphine-hydrochloride-combined-with-low-doses-of-bupivacaine-in-hemorrhoidectomy-a-clinical-randomised-trial
#10
Manuel Ruiz-Castro, Marta San José Santos, Antonio Rodríguez-Miguel, Francisco J de Abajo Iglesias
BACKGROUND: Intrathecal local anesthetics, associated or not to opioids, is commonplace in anorectal surgery, but it is unknown which is the option with the best risk-benefit ratio. The main aim was to assess whether the combination of morphine (50 mcg) with low-dose bupivacaine (3 mg) in an intradural solution has a better analgesic short-term effect than bupivacaine alone at standard doses (5 mg) in hemorrhoidectomy. METHODS: 66 patients of any sex were randomly assigned to two alternative treatments and 63 patients were considered valid for analysis...
March 3, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28176917/xiaozhi-decoction-reduced-posthemorrhoidectomy-pain-and-analgesic-medication-consumption-a-prospective-study
#11
Jianbin Shen, Xiagang Luo, Xiao Zhou, Chengwu Tang, Huanyu Ju, Yongqiang Xu, Lianjin Qin
OBJECTIVE: The aim of this study was to investigate the effect of Xiaozhi decoction (XZD) on posthemorrhoidectomy pain and analgesic medication consumption. METHODS: From May 2013 to March 2015, 315 patients who underwent open hemorrhoidectomy in our hospital were enrolled in this study, of whom, 160 patients were randomly assigned to accept sitz bath with warm water after hemorrhoidectomy (control group) and 155 patients were randomly assigned to accept sitz bath with XZD (XZD group) after hemorrhoidectomy...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28098569/human-papillomavirus-genotyping-of-incidental-malignant-and-premalignant-lesions-on-hemorrhoidectomy-specimens
#12
Yiang Hui, M Ruhul Quddus, Jayasimha N Murthy, Dongfang Yang, C James Sung, Shaolei Lu, Murray B Resnick, Li Juan Wang
Routine histopathologic examination of hemorrhoidectomy specimens is controversial having been described as not useful and expensive with few of these common cases demonstrating incidental lesions. However, unexpected premalignant and malignant lesions have been detected on excised hemorrhoids. The high-risk human papillomavirus (HR-HPV) types associated with these incidentally identified high-grade lesions are presently unknown. We aimed to identify cases of incidental high-grade anal intraepithelial neoplasia (HG-AIN) and anal squamous cell carcinoma incidentally discovered on hemorrhoidectomy specimens, genotype HR-HPVs from these lesions, and assess p53 and p16 expression by immunohistochemistry to identify risk factors for their development...
March 2017: American Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28071133/effect-of-transcutaneous-acupoint-electrical-stimulation-on-post-hemorrhoidectomy-associated-pain-anxiety-and-heart-rate-variability
#13
Mei-Ling Yeh, Yu-Chu Chung, Lun-Chia Hsu, Shuo-Hui Hung
Hemorrhoidectomy is the current best treatment for severe hemorrhoids, but it causes significant postoperative pain and anxiety, which is associated with heart rate variability (HRV). Transcutaneous acupoint electrical stimulation (TAES) was assumed to alleviate pain and anxiety, and modify the autonomic nervous system. This study aimed to examine the effects of TAES intervention on postoperative pain, anxiety, and HRV in patients who received a hemorrhoidectomy. A randomized-controlled trial with five repeated measures was conducted...
January 1, 2017: Clinical Nursing Research
https://www.readbyqxmd.com/read/27960130/is-the-severe-pain-after-milligan-morgan-hemorrhoidectomy-still-currently-remaining-a-major-postoperative-problem-despite-being-one-of-the-oldest-surgical-techniques-described-a-case-series-of-117-consecutive-patients
#14
Adrian Medina-Gallardo, Yuhamy Curbelo-Peña, Xavier De Castro, Pere Roura-Poch, Josep Roca-Closa, Enric De Caralt-Mestres
INTRODUCTION: Surgery is the only curative method of hemorrhoidal disease. Currently the Milligan-Morgan hemorrhoidectomy is still considered the "gold standard", since it is the best performing technique. However, postoperative pain remains a major problem. We analize the postoperative analgesic requirements for this procedure in 117 patients. PRESENTATION OF CASES: Between 2012 and 2013, 117 consecutive patients undergoing Milligan-Morgan hemorroidectomy, with an analysis of sex, age, total vascular anal cushions removed, hospital stay, complications, and relation with postoperative analgesic requirements...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27902953/rectal-free-perforation-after-stapled-hemorrhoidopexy-a-case-report-of-laparoscopic-peritoneal-lavage-and-repair-without-stoma
#15
Seokyong Ryu, Byung-Noe Bae
INTRODUCTION: Stapled hemorrhoidopexy is widely performed for treatment of prolapsed hemorrhoids because of advantages, including shorter hospital stay and less discomfort, compared with conventional hemorrhoidectomy. However, it can have severe adverse effects, such as rectal bleeding, perforation, and sepsis. PRESENTATION OF CASE: We report the case of a healthy 28-year-old man who presented to the emergency department with sudden-onset diffuse abdominal pain and hematochezia...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27895851/evaluating-the-safety-efficacy-and-complications-of-electrotherapy-and-its-comparison-with-conventional-method-of-hemorrhoidectomy
#16
Payam Nikooiyan, Hamzeh Mohammadi Sardo, Bahram Poursaeidi, Motahareh Zaherara, Bijan Ahmadi
AIM: This study was performed to evaluate the efficacy, safety and complications of electrotherapy compared with conventional hemorrhoidectomy (Ferguson technique). BACKGROUND: Ferguson hemorrhoidectomy is always associated with considerable pain and postoperative complications. Still, the electrotherapy method in which the hemorrhoidal tissue is not removed may not improve critical complications. PATIENTS AND METHODS: This randomized clinical trial was performed on patients with hemorrhoids referring to hospitals affiliated to the Kerman University of Medical Sciences during 2014-2015...
2016: Gastroenterology and Hepatology From Bed to Bench
https://www.readbyqxmd.com/read/27888438/transanal-hemorrhoidal-dearterialization-with-mucopexy-versus-open-hemorrhoidectomy-in-the-treatment-of-hemorrhoids-a-meta-analysis-of-randomized-control-trials
#17
L Xu, H Chen, G Lin, Q Ge, H Qi, X He
BACKGROUND: The aim of this study was to analyse the outcomes of transanal hemorrhoidal dearterialization with mucopexy (THDm) versus open hemorrhoidectomy (OH) in the management of hemorrhoids. METHODS: Randomized controlled trials in English were found by searching PubMed, Web of science, EMBASE, and the Cochrane Library database. Trials that compared THDm with OH were identified. Data were extracted independently for each study, and a meta-analysis was performed using fixed and random effects models...
December 2016: Techniques in Coloproctology
https://www.readbyqxmd.com/read/27806213/a-randomized-controlled-trial-comparing-laser-intra-hemorrhoidal-coagulation-and-milligan-morgan-hemorrhoidectomy
#18
Mohammad Naderan, Saeed Shoar, Mohammad Nazari, Ahmed Elsayed, Habibollah Mahmoodzadeh, Zhamak Khorgami
PURPOSE: To compare laser intra-hemorrhoidal coagulation with Milligan-Morgan (MM) hemorrhoidectomy. METHOD: Patients with symptomatic grade II or III internal hemorrhoids according to the Goligher's classification (refractory to medical treatment) were enrolled in this double-blinded randomized controlled trial study. In the laser group, hemorrhoidal columns were coagulated using a 980-nanometer (nm) radial laser emitting fiber (three, 15-W pulses of 1.2 s each, with 0...
November 2, 2016: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/27796581/treatment-of-accidental-perianal-injection-of-topical-thrombin-with-intravenous-antithrombin
#19
Vance G Nielsen, Samata R Paidy, Whitney McLeod, Alexandra Fox, Valentine N Nfonsam
While topical thrombin application can markedly improve surgical hemostasis, rapid absorption of thrombin can result in pulmonary embolism and death. We report a case of accidental interstitial infiltration of topical thrombin after hemorrhoidectomy that was treated with administration of human antithrombin and heparin anticoagulation. Except for a marked decrease in antithrombin activity from super normal to normal values, the patient exhibited no laboratory or clinical signs of pulmonary embolism, thrombin mediated consumptive loss of procoagulants, or regional thrombosis...
April 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/27768009/ligasuretm-hemorrhoidectomy-how-we-do
#20
Giovanni Milito, Giorgio Lisi, Elena Aronadio, Michela Campanelli, Dario Venditti, Simona Grande, Michele Grande
BACKGROUND: Hemorrhoidectomy is considered the gold standard and the most effective and definitive treatment for grades 3 or 4 hemorrhoids, and Milligan-Morgan's and Ferguson's procedures are the most widely used techniques throughout the world. The aim of the study was to present our surgical technique using LigasureTM vessel sealing, focus on technical aspects and surgical tricks showing our results with a huge number of patients and a long-term follow-up. METHODS: Between June 2001 and June 2014 at the University Hospital of Tor Vergata, Rome, Italy, 1000 patients were selected to underwent LigasureTM hemorrhoidectomy for III and IV degree hemorrhoids...
March 2017: Minerva Gastroenterologica e Dietologica
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