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Haemorrhoidectomy

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https://www.readbyqxmd.com/read/28989595/haemorrhoids-an-update-on-management
#1
REVIEW
Steven R Brown
Haemorrhoids are common, affecting up to one quarter of all adults according to some estimates. Numerous interventions exist for their management, ranging from topical and medical therapies to outpatient treatments and surgical interventions that aim to fix or excise. Given the polysymptomatic nature of the disease, it is difficult to effectively judge which treatment option is best. Recently introduced novel haemorrhoid management techniques, such as stapled haemorrhoidopexy, Ligasure™ excision and haemorrhoidal artery ligation, aim to reduce harm whilst maintaining or improving on outcome...
October 2017: Therapeutic Advances in Chronic Disease
https://www.readbyqxmd.com/read/28794872/thd-and-mucopexy-efficacy-and-controversy
#2
Haytham Abudeeb, Ajogwu Ugwu, Jamshid Darabnia, Ahmed Hammad, Khurram Khan, Min Maung, Elizabeth McNulty, Abdul Latif Khan, Arijit Mukherjee
AIMS: Transanal haemorrhoidal dearterialisation and mucopexy has evolved in recent years as a popular minimally invasive non-excisional surgery for symptomatic prolapsing haemorrhoids. The long-term outcome of this procedure however, remains to be established. We aim to analyse the long-term outcome of THD-mucopexy in the management of prolapsing haemorrhoids based on the evidence of a prospective data from a single institution. METHODS: A prospective data was collected on 100 consecutive cases of grade 3 and 4 symptomatic haemorrhoids between the period 03/2010 and 06/2015 who underwent the procedure as a day case under general anaesthetic...
September 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28589634/systematic-review-and-meta-analysis-of-the-role-of-metronidazole-in-post-haemorrhoidectomy-pain-relief
#3
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/28552393/-comparative-analysis-of-efficiency-indicators-in-ambulatory-surgery
#4
María Rodríguez Ortega, José Luis Porrero Carro, Jesús María Aranaz Andrés, María José Castillo Fe, María Teresa Alonso García, Carlos Sánchez-Cabezudo Díaz-Guerra
OBJECTIVE: To find comparative elements for quality control in major ambulatory surgery (MAS) units. METHOD: Descriptive and comparative study of the Ambulatory Care Index (AI) and Substitution Index (SI) in the Santa Cristina Hospital Surgery Service (Madrid, Spain) compared to Key Indicators (KI) of the National Health Service (NHS). RESULTS: 7,817 MAS procedures (between 2006 and 2014) were analysed. The average annual AI was 54%, higher (p <0...
May 25, 2017: Gaceta Sanitaria
https://www.readbyqxmd.com/read/28211047/reasons-for-rarity-of-anal-melanocytic-naevi
#5
Eman Aljufairi, Fayek Alhilli
In the last 16 years only seven definite cases of anal melanocytic naevi have been reported in the literature. We describe three new cases, none of which were suspected clinically and were incidentally diagnosed on histological examination of haemorrhoidectomy specimens. The infrequency of these special site flexural melanocytic lesions may be related to changes in the involutionary mechanisms of the anal melanocyte proliferation. However, other factors related to the low detection rates by clinicians and pathologists need also to be considered...
February 17, 2017: Australasian Journal of Dermatology
https://www.readbyqxmd.com/read/27921992/the-hubble-trial-haemorrhoidal-artery-ligation-hal-versus-rubber-band-ligation-rbl-for-symptomatic-second-and-third-degree-haemorrhoids-a-multicentre-randomised-controlled-trial-and-health-economic-evaluation
#6
Steven Brown, Jim Tiernan, Katie Biggs, Daniel Hind, Neil Shephard, Mike Bradburn, Allan Wailoo, Abualbishr Alshreef, Lizzie Swaby, Angus Watson, Simon Radley, Oliver Jones, Paul Skaife, Anil Agarwal, Pasquale Giordano, Marc Lamah, Mark Cartmell, Justin Davies, Omar Faiz, Karen Nugent, Andrew Clarke, Angus MacDonald, Phillip Conaghan, Paul Ziprin, Rohit Makhija
BACKGROUND: Optimal surgical intervention for low-grade haemorrhoids is unknown. Rubber band ligation (RBL) is probably the most common intervention. Haemorrhoidal artery ligation (HAL) is a novel alternative that may be more efficacious. OBJECTIVE: The comparison of HAL with RBL for the treatment of grade II/III haemorrhoids. DESIGN: A multicentre, parallel-group randomised controlled trial. PERSPECTIVE: UK NHS and Personal Social Services...
November 2016: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/27845508/may-radiofrequency-be-the-best-choice-for-iii-iv-degree-hemorrhoids
#7
Giovanni Milito, Giorgio Lisi, Elena Aronadio, Michela Campanelli, Dario Venditti, Simona Grande, Michele Grande
BACKGROUND: Hemorrhoidectomy is considered the most efficient method to treat hemorrhoids of III and IV grades. The aim of this study was to compare conventional diathermy hemorrhoidectomy and radiofrequency hemorrhoidectomy based on a large series of patients. METHODS: Between June 2001 and June 2014, 1000 patients have been treated with radiofrequency hemorrhoidectomy (group A) and 500 patients have been treated with diathermy (group B) as a day-case procedure...
March 2017: Minerva Gastroenterologica e Dietologica
https://www.readbyqxmd.com/read/27766395/evidence-based-management-of-pain-after-excisional-haemorrhoidectomy-surgery-a-prospect-review-update
#8
REVIEW
Tarik Sammour, Ahmed W H Barazanchi, Andrew G Hill
BACKGROUND: The aim of this systematic review was to update previous PROSPECT ( http://www.postoppain.org ) review recommendations for the management of pain after excisional haemorrhoidectomy. METHODS: Randomized studies and reviews published in the English language from July 2006 (end date of last review) to March 2016, assessing analgesic, anaesthetic, and operative interventions pertaining to excisional haemorrhoidectomy in adults, and reporting pain scores, were retrieved from the EMBASE and MEDLINE databases...
February 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/27621519/effect-of-karamard%C3%A4-di-yoga-versus-diclofenac-sodium-in-post-operative-pain-management-a-randomized-comparative-clinical-trial
#9
Rahul Hegana, Hemant Devaraj Toshikhane, Sangeeta Toshikhane, Hetal Amin
INTRODUCTION: Post-operative pain is Nociceptive i.e., anticipated unavoidable physiological pain which is caused due to tissue trauma. Drugs such as NSAIDs (Non Steroidal Anti Inflammatory Drugs) and Opioids are used for post-operative pain management but are associated with their own drawbacks. Karamardādi Yoga has been in use in Ayurvedic practice for analgesia. It is known to relieve pain and can be used to supplement anaesthesia and also get rid of adverse effect of modern analgesic drugs...
April 2016: Ancient Science of Life
https://www.readbyqxmd.com/read/27375709/comparison-of-hemorrhoidectomy-by-ligasure-with-conventional-milligan-morgan-s-hemorrhoidectomy
#10
Nighat Bakhtiar, Foad Ali Moosa, Farhat Jaleel, Naeem Akhtar Qureshi, Masood Jawaid
OBJECTIVE: To compare the efficacy of haemorrhoidectomy done by using LigaSure with conventional Milligan Morgan haemorrhoidectomy. METHODS: This randomized controlled trial was done at Department of Surgery Dow University Hospital Karachi during January 2013 to September 2015. A total of 55 patients were included in the study. Patients were randomly allocated to group A (Haemorrhoidectomy by Ligasure) and group B (Milligan Morgan Haemorrhoiectomy). Efficacies of both procedures were compared by operative time, Blood loss, wound healing, and pain score on immediate, 1st and 7(th) post operative day...
May 2016: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/27212575/manual-reduction-in-acute-haemorrhoids
#11
F Gaj, L Candeloro, I Biviano
AIM: In prolapsed internal hemorrhoids exposed outside the anus, manually reducing the prolapse with 48 hours of commencement of anal pain, decreased the progression of thrombosis. The aim of our study was to evaluate the effects of manual reduction of the inflamed piles hemorrhoids. MATERIALS OF STUDY: Eleven patients, 7 males and 4 pregnant females (in early post partum) with an average age of 34 years ± 8 (range 23- 52) were enrolled with anal pain cause by haemorrhoidal congestion, but prior to full blown thrombosis...
March 2016: La Clinica Terapeutica
https://www.readbyqxmd.com/read/27179281/symptoms-of-obstructive-defecation-syndrome-functional-outcome-after-stapled-haemorrhoidectomy
#12
Aldo Bove, Vincenzo D'Addetta, Gino Palone, Tarcisio Paniccia, Stella Chiarini, Alfonso Lapergola, Giuseppe Bongarzoni
BACKGROUND: Patients with haemorrhoids often present obstructive defecation symptoms. Preoperative they can be classified in three groups: slight, severe and mild symptoms. Aim of this study was to postoperatively evaluate functional outcome in patients who underwent stapled haemorrhoidectomy in mild obstructive defecation syndrome. METHODS: We enrolled 98 patients with mild obstructive defecation symptoms using Wexner score preoperatively (range 8-16) from the 332 consecutive patients treated with stapled haemorrhoidectomy between January 2009 and December 2011...
2016: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/27023348/comments-to-rubber-band-ligation-versus-excisional-haemorrhoidectomy-for-haemorrhoids
#13
REVIEW
S R Brown, A Watson
OBJECTIVE: To review the efficacy and safety of the two most popular conventional methods of haemorrhoidal treatment, rubber band ligation and excisional haemorrhoidectomy (EH). The original study has now been updated using the same search strategy. SEARCH METHODS: We searched MEDLINE, EMBASE, CENTRAL, and CINAHL up to October 2010. SELECTION CRITERIA: Randomised controlled trials comparing rubber band ligation with EH for symptomatic haemorrhoids in adult human patients were included...
September 2016: Techniques in Coloproctology
https://www.readbyqxmd.com/read/27021482/antibiotics-and-antiseptics-for-surgical-wounds-healing-by-secondary-intention
#14
REVIEW
Gill Norman, Jo C Dumville, Devi Prasad Mohapatra, Gemma L Owens, Emma J Crosbie
BACKGROUND: Following surgery, incisions are usually closed by fixing the edges together with sutures (stitches), staples, adhesives (glue) or clips. This process helps the cut edges heal together and is called 'healing by primary intention'. However, a minority of surgical wounds are not closed in this way. Where the risk of infection is high or there has been significant loss of tissue, wounds may be left open to heal by the growth of new tissue rather than by primary closure; this is known as 'healing by secondary intention'...
March 29, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27011593/stapled-haemorrhoidectomy-experience-with-modified-anoscope
#15
Sisir Kumar Nath
Stapled haemorrhoidectomy (SH) is gradually becoming popular. Though it is a "patient friendly" procedure, it has not become the "gold standard". About 15 % complication rate is reported. A perfect purse-string can avoid many of the complications. The author has made a semicircular hole in the anoscope, which has helped in taking the purse-string at proper depth and at proper distance from the dentate line. A total of 72 cases of SH are performed without any complication. Histopathological examination of donoughts in the first 20 cases shows excision up to the submucosa in 16 cases...
December 2015: Indian Journal of Surgery
https://www.readbyqxmd.com/read/27004324/comparison-of-open-and-closed-techniques-of-haemorrhoidectomy-in-terms-of-post-operative-complications
#16
RANDOMIZED CONTROLLED TRIAL
Shahid Majeed, Syeda Rifaat Qamar Naqvi, Mohammad Tariq, Mohammad Asghar Ali
BACKGROUND: Haemorrhoids have been diagnosed and treated since the dawn of civilization, yet their cause, nature, symptomatology and especially their treatment options, remain hotly debated. The general principle however is that treatment should be directed by symptoms and the degree of haemorrhoids. The objective of the study is to compare early and late complications and wound healing time in open versus closed methods of haemorrhoidectomy. METHODS: This was a Randomized control trial conducted at Department of Surgery CMH Kharian for a period of 3 years...
October 2015: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/26813541/milligan-morgan-open-versus-ferguson-haemorrhoidectomy-closed-a-systematic-review-and-meta-analysis-of-published-randomized-controlled-trials
#17
REVIEW
Muhammad I Bhatti, Muhammad Shafique Sajid, Mirza K Baig
OBJECTIVE: The purpose of this article is to systematically analyse the randomized, controlled trials (RCTs) comparing Ferguson or closed haemorrhoidectomy (CH) versus open haemorrhoidectomy (OH) or Milligan-Morgan haemorrhoidectomy in the management of haemorrhoidal disease (HD). METHODS: RCTs on the effectiveness of CH and OH in the management of HD were analysed systematically using RevMan(®), and combined outcome was expressed as odds ratio (OR) and standardized mean difference...
June 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/26796256/symptoms-of-obstructive-defecation-syndrome-functional-outcome-after-stapled-haemorrhoidectomy
#18
Aldo Bove, Vincenzo D'Addetta, Gino Palone, Tarcisio Paniccia, Stella Chiarini, Alfonso Lapergola, Giuseppe Bongarzoni
BACKGROUND: Patients with haemorrhoids often present obstructive defecation symptoms. Preoperative they can be classified in three groups: slight, severe and mild symptoms. Aim of this study was to postoperatively evaluate functional outcome in patients who underwent stapled haemorrhoidectomy in mild obstructive defecation syndrome. METHODS: We enrolled 98 patients with mild obstructive defecation symptoms using Wexner score preoperatively (range 8-16) from the 332 consecutive patients treated with stapled haemorrhoidectomy between January 2009 and December 2011...
December 18, 2015: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/26713434/risk-of-post-discharge-venous-thromboembolism-and-associated-mortality-in-general-surgery-a-population-based-cohort-study-using-linked-hospital-and-primary-care-data-in-england
#19
George Bouras, Elaine Marie Burns, Ann-Marie Howell, Alex Bottle, Thanos Athanasiou, Ara Darzi
BACKGROUND: Trends towards day case surgery and enhanced recovery mean that postoperative venous thromboembolism (VTE) may increasingly arise after hospital discharge. However, hospital data alone are unable to capture adverse events that occur outside of the hospital setting. The National Institute for Health and Care Excellence has suggested the use of primary care data to quantify hospital care-related VTE. Data in surgical patients using these resources is lacking. The aim of this study was to measure VTE risk and associated mortality in general surgery using linked primary care and hospital databases, to improve our understanding of harm from VTE that arises beyond hospital stay...
2015: PloS One
https://www.readbyqxmd.com/read/26561592/haemorrhoids-modern-diagnosis-and-treatment
#20
REVIEW
J R F Hollingshead, R K S Phillips
Haemorrhoids present often to primary and secondary care, and haemorrhoidal procedures are among the most common carried out. They may co-exist with more serious pathology, and correct evaluation is important. In most cases a one-off colonoscopy in patients aged 50 or above with flexible sigmoidoscopy in younger patients is reasonable. Many people with haemorrhoids do not require treatment. Topical remedies provide no more than symptomatic relief-and even evidence for this is poor. Bulk laxatives alone may improve symptoms of both bleeding and prolapse and seem as effective as injection sclerotherapy...
January 2016: Postgraduate Medical Journal
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