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hemorrhoidectomy

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https://www.readbyqxmd.com/read/29743886/efficacy-of-mesoglycan-in-pain-control-after-excisional-hemorrhoidectomy-a-pilot-comparative-prospective-multicenter-study
#1
Gaetano Gallo, Massimiliano Mistrangelo, Roberto Passera, Valentina Testa, Mauro Pozzo, Roberto Perinotti, Ivan Lanati, Ivano Lazzari, Paolo Tonello, Elettra Ugliono, Emilia De Luca, Alberto Realis Luc, Giuseppe Clerico, Mario Trompetto
Introduction: Various pain management strategies for patients undergoing open excisional hemorrhoidectomy have been proposed, yet postoperative pain remains a frequent complaint. Objective: To determine whether mesoglycan (30 mg two vials i.m. once/day for the first 5 days postoperative, followed by 50 mg 1 oral tablet twice/day for 30 days) would reduce the edema of the mucocutaneous bridges and thus improve postoperative pain symptoms. Patients and Methods: For this prospective observational multicenter study, 101 patients undergoing excisional diathermy hemorrhoidectomy for III-IV degree hemorrhoidal disease were enrolled at 5 colorectal referral centers...
2018: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/29721732/a-prospective-randomized-double-blind-study-of-pain-control-by-topical-calcium-channel-blockers-versus-placebo-after-milligan-morgan-hemorrhoidectomy
#2
Sunandan Yadav, Radha Govind Khandelwal, Prabha Om, K Ravindra, Kanhaiya Lal Choudhary
INTRODUCTION: Post-hemorrhoidectomy pain is significantly associated with a hypertonicity of the internal anal sphincter. We evaluated the effects of topical diltiazem, a calcium channel blocker, in reducing pain after hemorrhoidectomy. Purpose of our study was to determine difference in extent of pain control by application of topical calcium channel blocker (diltiazem 2%) versus placebo ointment. METHODS: This was a prospective randomized double-blind clinical study conducted at Sawai Man Singh Hospital, Jaipur, from May 2016 to May 2017...
May 2, 2018: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/29665978/outpatient-intravenous-multimodal-elastomeric-pump-with-methadone-in-ambulatory-surgery
#3
L Gómez-López, X Sala-Blanch, P L Gambús Cerrillo, A López Gutiérrez, M Agustí Lasús, M T Anglada Casas
BACKGROUND AND OBJECTIVE: Analgesia in Ambulatory Surgery (AS) needs to evolve in parallel with surgical complexity. We designed a study to try to improve analgesia in painful surgery using an intravenous elastomeric pump. As a novelty, methadone was included. PATIENTS AND METHODS: An observational study, physical status ASA I-II, underwent ambulatory surgeries with moderate-severe postoperative pain. Analgesia was administered for 48h by an intravenous multimodal elastomeric pump (methadone, tramadol, dexketoprofen and ondansetron at low doses)...
April 14, 2018: Revista Española de Anestesiología y Reanimación
https://www.readbyqxmd.com/read/29652112/mucopexy-recto-anal-lifting-mu-ral-a-standardized-minimally-invasive-method-of-managing-symptomatic-hemorrhoids-with-an-innovative-suturing-technique-and-the-hemorpex-system%C3%A2
#4
Claudio Pagano, Contardo Vergani, Carlo Invernizzi, Massimo Bussone, Guido Benegiamo, Marco Venturi
BACKGROUND: Conservative surgery of hemorrhoidal disease is less painful than traditional hemorrhoidectomy, and mucopexy has less risk of serious postoperative complications than stapled hemorrhoidopexy. The aim of this study was to evaluate the safety and effectiveness of a standardized, modified hemorrhoidopexy, named Mucopexy-Recto Anal Lifting (MuRAL),with the HemorPex System (HPS) in patients with symptomatic III and IV degree hemorrhoids. MATERIALS AND METHODS: Patients were enrolled from May 2013 to Dec 2015 and operated on with the MuRAL technique, based on arterial ligation and mucopexy at 6 locations, using a standardized clockwise/anti-clockwise rotation sequence of the HPS anoscope...
April 12, 2018: Minerva Chirurgica
https://www.readbyqxmd.com/read/29643327/comparison-of-effects-of-vessel-sealing-devices-and-conventional-hemorrhoidectomy-on-postoperative-pain-and-quality-of-life
#5
Murat Kendirci, İbrahim Tayfun Şahiner, Yeliz Şahiner, Güven Güney
BACKGROUND The aim of this study was to investigate the early and late results of use of LigaSure, Harmonic Scalpel, and conventional hemorrhoidectomy in hemorrhoidectomy, to determine the least painful method, and to investigate the relationship between pain perception and personal differences in hemorrhoid bundles. MATERIAL AND METHODS Ninety patients undergoing hemorrhoidectomy between 2014 and 2017 were retrospectively evaluated. We investigated the duration of hospitalization and the presence of bleeding, incontinence, perianal wetness, urinary retention, stenosis, and recurrence during follow-up after surgery...
April 12, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/29628551/perianal-block-is-it-as-good-as-spinal-anesthesia-for-closed-hemorrhoidectomies
#6
Kavitha Jinjil, Deepak Dwivedi, Vidhu Bhatnagar, Rahul K Ray, Swayam Tara
Background and Aims: This study compared if perianal block using ropivacaine and dexmedetomidine was as good as spinal anesthesia (SA) using bupivacaine (heavy) for closed hemorrhoidectomies. Methods: A prospective randomized study was conducted in sixty patients who underwent closed hemorrhoidectomy. Thirty patients of Group A received SA. Thirty patients in Group B received local perianal block. Patients were evaluated for onset of the block, total pain-free period, and time to ambulation...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29546558/a-national-evaluation-of-the-management-practices-of-hemorrhoidal-disease-in-the-netherlands
#7
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...
May 2018: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/29521831/stapled-hemorrhoidopexy-results-at-10-year-follow-up
#8
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
https://www.readbyqxmd.com/read/29508023/anoplasty-for-post-hemorrhoidectomy-low-anal-stenosis-a-new-technique
#9
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
https://www.readbyqxmd.com/read/29431977/hemorrhoids-diagnosis-and-treatment-options
#10
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
https://www.readbyqxmd.com/read/29399307/the-clinical-efficacy-of-infrared-photocoagulation-versus-closed-hemorrhoidectomy-in-treatment-of-hemorrhoid
#11
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
https://www.readbyqxmd.com/read/29260125/comparison-of-the-reliability-and-efficacy-of-ligasure-hemorrhoidectomy-and-a-conventional-milligan-morgan-hemorrhoidectomy-in-the-surgical-treatment-of-grade-3-and-4-hemorrhoids
#12
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
https://www.readbyqxmd.com/read/29172862/comparison-of-two-methods-spinal-anesthesia-and-ischiorectal-block-on-post-hemorrhoidectomy-pain-and-hospital-stay-a-randomized-control-trial
#13
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
https://www.readbyqxmd.com/read/29076869/hemorrhoids-what-are-the-options-in-2018
#14
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
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
#15
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
#16
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
#17
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
#18
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
#19
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
https://www.readbyqxmd.com/read/28932913/a-prospective-randomized-controlled-trial-evaluating-the-short-term-outcomes-of-transanal-hemorrhoidal-dearterialization-versus-tissue-selecting-technique
#20
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
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