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https://www.readbyqxmd.com/read/29076869/hemorrhoids-what-are-the-options-in-2018
#1
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...
October 25, 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/29071068/the-ligament-of-parks-as-a-key-anatomical-structure-for-safer-hemorrhoidectomy-anatomic-study-and-a-simple-surgical-note
#2
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
https://www.readbyqxmd.com/read/29051401/symptomatic-pile-tailored-procedure-a-new-perspective-for-hemorrhoidal-disease-treatment
#3
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
https://www.readbyqxmd.com/read/29027878/are-prophylactic-antibiotic-agents-indicated-in-anorectal-surgery-for-patients-with-human-immunodeficiency-virus
#4
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
https://www.readbyqxmd.com/read/28956135/procedure-for-prolapse-and-hemorrhoids-pph-with-low-rectal-anastomosis-using-a-pph-03-stapler-low-rate-of-recurrence-and-postoperative-complications
#5
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
https://www.readbyqxmd.com/read/28944332/the-whitehead-operation-procedure-is-it-a-useful-technique
#6
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: Turk J Surg
https://www.readbyqxmd.com/read/28932913/a-prospective-randomized-controlled-trial-evaluating-the-short-term-outcomes-of-transanal-hemorrhoidal-dearterialization-versus-tissue-selecting-technique
#7
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
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
#8
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
#9
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
https://www.readbyqxmd.com/read/28863202/immigrant-with-stomach-pain-distension-nausea-and-fever-%C3%A2-dx
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
RANDOMIZED CONTROLLED TRIAL
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
#19
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
#20
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
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