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hemorrhoidectomy

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https://www.readbyqxmd.com/read/28918703/a-randomized-multicenter-clinical-trial-of-rph-with-the-simplified-milligan-morgan-hemorrhoidectomy-in-the-treatment-of-mixed-hemorrhoids
#1
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
https://www.readbyqxmd.com/read/28871428/a-prospective-randomized-trial-of-transanal-hemorrhoidal-dearterialization-with-mucopexy-versus-ultrasonic-scalpel-hemorrhoidectomy-for-grade-iii-hemorrhoids
#2
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...
September 4, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28863202/immigrant-with-stomach-pain-distension-nausea-and-fever-%C3%A2-dx
#3
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
https://www.readbyqxmd.com/read/28804904/early-impact-on-outpatients-of-mandatory-adoption-of-the-diagnosis-related-group-based-reimbursement-system-in-korea-on-use-of-outpatient-care-differences-in-medical-utilization-and-presurgery-examination
#4
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
https://www.readbyqxmd.com/read/28749789/surgical-approach-to-piles-at-risk-of-severe-postoperative-pain-tricks-and-tips
#5
Domenico Tuscano, Linda D'Amore, Fabio Gaj, Paolo Bruzzone, Elena Annesi, Daniele Ceccarelli, Paolox 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...
July 24, 2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28698000/topical-diltiazem-ointment-in-post-hemorrhoidectomy-pain-relief-a-meta-analysis-of-randomized-controlled-trials
#6
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
https://www.readbyqxmd.com/read/28682002/laparoscopic-low-anterior-resection-for-rectal-cancer-after-whitehead-s-hemorrhoidectomy-a-case-report
#7
Yoshihiro Takemoto, Eijiro Harada, Yuriko Takeuchi, Daichi Kawamura, Yuuki Suehiro, Naruji Kugimiya, Kimikazu Hamano
A 65-year-old man presented with bloody stool. Colonoscopy revealed a raised tumor in the rectum, above the peritoneal reflection. He underwent endoscopic mucosal resection, but the pathological findings suggested the possibility of residual cancer. We performed laparoscopic low anterior resection using a circular stapling instrument for additional curative surgery. However, we could not insert the shaft of the endoscopic circular stapler from the anus because of anal stenosis due to Whitehead's hemorrhoidectomy the patient had undergone 20 years earlier...
July 6, 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/28658138/a-novel-technique-for-the-treatment-of-stages-iii-to-iv-hemorrhoids-homemade-anal-cushion-suspension-clamp-combined-with-harmonic-scalpel
#8
Guoqiang Lin, Qiongxiang Ge, Xiaokang He, Haixin Qi, Li Xu
To compare the efficacy of homemade anal cushion suspension clamp combined with harmonic scalpel (ACS) and Milligan-Morgan hemorrhoidectomy combined with electric knife (MMH) in the treatment of stages III to IV hemorrhoids. We conducted a retrospective study of 99 patients with stages III to IV hemorrhoids hospitalized from January to December in 2013. Among them, 51 patients were treated with ACS, while 48 patients received MMH. Data from clinical recording and follow-up included operative time, intraoperative blood loss, hospitalization information, postoperative pain, and postoperative complications...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28652418/enhancement-of-wound-healing-by-the-traditional-chinese-medicine-herbal-mixture-sophora-flavescens-in-a-rat-model-of-perianal-ulceration
#9
Xiaoping Xu, Xiaohua Li, Lei Zhang, Zhaohui Liu, Yuan Pan, Dong Chen, Donghua Bin, Qun Deng, Y U Sun, Robert M Hoffman, Zhijian Yang, Hong Yuan
BACKGROUND/AIM: Hemorrhoidectomy is often associated with significant postoperative complications that may result in slow wound healing. The traditional Chinese medicine (TCM) compound Sophora flavescens (CSF) has shown efficacy on many inflammatory disorders. The aim of the present study was to examine the efficacy of CSF on wound healing in a rat model of perianal ulceration. MATERIALS AND METHODS: A rat model of perianal ulceration was induced by subcutaneous injection of 75% glacial acetic acid...
July 2017: In Vivo
https://www.readbyqxmd.com/read/28589634/systematic-review-and-meta-analysis-of-the-role-of-metronidazole-in-post-haemorrhoidectomy-pain-relief
#10
REVIEW
N J R Lyons, J B Cornille, S Pathak, P Charters, I R Daniels, N J Smart
AIM: Conventional haemorrhoidectomy is still considered the reference standard for the management of severe or recurrent haemorrhoids. Pain is reported by patients to be the most common postoperative complication. Although the literature lacks a consensus on its effectiveness, metronidazole is often used to reduce postoperative pain. We have performed a meta-analysis of all randomized controlled trials (RCTs) that investigated the use of metronidazole for pain relief after haemorrhoidectomy...
September 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
#11
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 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
#12
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
#13
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...
May 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
#14
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
#15
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)...
June 21, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28398580/how-did-market-competition-affect-outpatient-utilization-under-the-diagnosis-related-group-based-payment-system
#16
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...
June 1, 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
#17
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
#18
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-randomized-trial
#19
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: Sixty-six patients of any sex were randomly assigned to two alternative treatments and 63 patients were considered valid for analysis...
September 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28176917/xiaozhi-decoction-reduced-posthemorrhoidectomy-pain-and-analgesic-medication-consumption-a-prospective-study
#20
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
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