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The study of hemorrhoid cases in children in Amir-Kabir and Bahrami hospitals, 1362-78
Poorang H
Tehran University Medical Journal , 2000,
Abstract: Hemorrhoid is one of the anorectal disorders in children, which is reported to be complication of portal hypertension. This condition is not common in children. We found only 7 cases from 30000 operation done in Tehran university hospital on pediatric group between 1983-99. The main complain of these 7 cases was anorectal mass (43%) and pain due to thrombosis (28.5%) treatment of all 7 cases was successful and no other pathology found.
Perianal and Gluteal Burn as a Complication of Hemorrhoid Treatment Caused by Bidet
Celalettin Sever,Yalcin Kulahci,Haluk Duman
Journal of Clinical and Analytical Medicine , 2011, DOI: 10.4328
Abstract: Contact with hot objects and surfaces often causes burns. We present a case of burn injury in the perianal region caused by use of a bidet to relieve the pain caused by hemorrhoid.This case report supports an ultimate need for further development and actual implementation of preventative measures for hot water contact burns in the homes of people who are at greatest risk.
Outcome of manual hemorrhoidopexy in the management of hemorrhoids
Sujit Kumar,P Kafle,SJ Shrestha,S Agrawal,BN Patowary
Journal of College of Medical Sciences-Nepal , 2013, DOI: 10.3126/jcmsn.v9i2.9682
Abstract: Background:? Manual hemorrhoidopexy is a new technique of treating second degree hemorrhoids. In contrast to the conventional resectional techniques (Milligan-Morgan), manual hemorrhoidopexy is a novel technique as described by T Carlo. It does not involve excision but plication with fixation of the prolapsing hemorrhoid. Objective:? To study the outcome of manual hemorrhoidopexy and to compare manual hemorrhoidopexy with the traditional hemorrhoidectomy. Methods:? This is a prospective study conducted over 16 months (January 2012 to April 2013) in the College of Medical Sciences Teaching Hospital (COMS-TH), Bharatpur, Chitwan, Department of Surgery. The patients who presented with third degree internal-hemorrhoids on a random basis, and underwent either conventional hemorrhoidectomy (Group A) or Manual hemorrhoidopexy (Group B) by senior consultant surgeons were included. The patients who had external hemorrhoids in addition to internal were excluded. Preoperative, intraoperative, and postoperative characteristics were evaluated. Results:? Twenty five patients with median age group 42.5 years underwent conventional (Milligan-Morgan) hemorrhoidectomy (Group A) and 25 patients with mean age of 40.1 years underwent manual hemorrhoidopexy (Group B). Male patients were predominant in both groups. The patients in group A had more postoperative pain as compared to group B (as assessed by the visual analogue scale and requirement of post-operative analgesic) and this was statistically significant (p<0.001). There was no significant difference among the other post-operative urinary retention. Twelve percent (n=3) patients in group A had post-operative bleeding and only 4% (n=1) in group B which was statistically significant (p<0.001). Mean duration of hospital stay in group A was 2.5 days as compared to 1.5 day in group B. Median follow up in both the study group was 3 (2-4) months. Conclusion:? Manual hemorrhoidopexy has comparable outcomes in term of postoperative analgesic requirement, and post operative complications. Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-2, 15-19 DOI: http://dx.doi.org/10.3126/jcmsn.v9i2.9682
Tratamento da doen?a hemorroidária com ligadura elástica: estudo prospectivo com 59 pacientes
Motta, Marcel Machado da;Silva Júnior, José Batista da;Santana, Larice Oliveira;Ferdandes, Igor Lima;Moura, Alex Rodrigues;Prudente, Ana Carolina Lisboa;Torres Neto, Juvenal da Rocha;
Revista Brasileira de Coloproctologia , 2011, DOI: 10.1590/S0101-98802011000200005
Abstract: rubber band ligation (rb) is considered a minimally invasive method for the treatment of hemorrhoidal disease (hd) and has advantages in relation to hemorrhoidectomy whereby: simplicity of execution, outpatient realization and no need of anesthesia. it is an effective method, especially in the hd grade ii. however, shows complications, and the most frequents are: anal pain, tenesmus, hematochezia and urinary retention. some studies have shown severe complications as major bleeding that needs blood transfusion. thus, this study evaluated the effectiveness and the morbidity of the treatment of hd by the method of rb. it was a prospective study with 59 patients. five (8,5%) patients had hd graded in the first degree, 33 (55,9%) in the second degree and 21 (35,6%) in the third. all patients were submitted to at least two sessions. in the 135 sessions performed, we found: hematochezia in 62 (45.9%), severe pain in 39 (28.9%), vagal symptoms in 10 (7.4%) and pseudostrangulation in 1 (0.7%) session. the cure rate of hemorrhoidal prolapse among patients with hd grade ii was 87.9% and among those with hd grade iii, 76.2%. the treatment of hd by the method of rb proved to be safe and with good cure rate.
Doppler-guided hemorrhoidal artery ligation in the management of symptomatic hemorrhoids
Ramírez,J. M.; Aguilella,V.; Elía,M.; Gracia,J. A.; Martínez,M.;
Revista Espa?ola de Enfermedades Digestivas , 2005, DOI: 10.4321/S1130-01082005000200004
Abstract: objective: the aim of this study is to clinically test the efficacy of a new approach for patients having symptomatic grade iii and iv hemorrhoids. material and method: 32 patients (17 females) complaining of grade iii or iv hemorrhoids were included in the study. a specially designed proctoscope coupled with a doppler transducer on its tip was used to identify the hemorrhoidal arteries, which were afterwards suture ligated. operating time as well as per- and post-operative complications were anlyzed. follow-up was planned following discharge after 1 week, 1 month, 6 months and 1 year. results: mean operation time was 27 (range 18-43) minutes, and 5 (range 4-7) arteries were located on average. no patient had severe or moderate postoperative pain, with anal discomfort being the main complaint. rectal bleeding and tenesmus were the commonest post-operative complications. after one year of follow-up, 19 patients were free of symptoms and 6 of them had significant symptom relief. according to grade, the technique failed in just 3 grade iii patients, but in as many as 4 grade iv hemorrhoid cases. conclusions: doppler-guided hemorrhoid artery ligation is an easy-to-perform technique that is well accepted by patients and has good results for grade iii hemorrhoids.
Intractable bleeding from hemorrhoid piles after Stapled Hemorrhoidopexy: Case report
Aziz Sümer,Ne?et K?ksal,Ediz Alt?nl?
Medical Journal of Bakirk?y , 2007,
Abstract: Stapled hemorrhoidopexy is a new approach to the treatment of hemorrhoids. Stapled hemorrhoidopexy has recently become a widely accepted procedure for second and third degree hemorrhoids. In comparison to conventional hemorrhoidectomy, the reduction of postoperative pain and the shorter hospital stay made stapled hemorrhoidopexy a recommended surgical procedure. Various authors have reported multiple complications, including persistent anorectal pain, faecal urgency, stricture formation, recurrent prolapses, pelvic sepsis, rectal perforations and bleeding. The aim of this study is to evaluate a case along with literature who had intractable bleeding from hemorrhoid piles after stapled hemorrhoidopexy.
Long-term outcome and efficacy of endoscopic hemorrhoid ligation for symptomatic internal hemorrhoids
Ming-Yao Su,Cheng-Tang Chiu,Wei-Pin Lin,Chen-Ming Hsu
World Journal of Gastroenterology , 2011, DOI: 10.3748/wjg.v17.i19.2431
Abstract: AIM: To assess the long-term outcome of endoscopic hemorrhoid ligation (EHL) for the treatment of symptomatic internal hemorrhoids. METHODS: A total of 759 consecutive patients (415 males and 344 females) were enrolled. Clinical presentations were rectal bleeding (593 patients) and mucosal prolapse (166 patients). All patients received EHL at outpatient clinics. Hemorrhoid severity was classified by Goligher’s grading. The mean follow-up period was 55.4 mo (range, 45-92 mo). RESULTS: The number of band ligations averaged 2.35 in the first session for bleeding and 2.69 for prolapsed patients. Bleeding was controlled in 587 (98.0%) patients, while prolapse was reduced in 137 (82.5%) patients. After treatment, 93 patients experienced anal pain and 48 patients had mild bleeding. Patient subjective satisfaction was 93.6%. Repeat treatment or surgery was performed if symptoms were not relieved in the first session. In the bleeding group, the recurrence rate was 3.7% (22 patients) at 1 year, and 6.6% and 13.0% at 2 and 5 years. In the prolapsed group, the recurrence rate was 3.0%, 9.6% and 16.9% at 1, 2 and 5 years, respectively. CONCLUSION: EHL is an easy and well-tolerated procedure for the treatment of symptomatic internal hemorrhoids, with good long-term results.
Post hemorrhoidectomy pain control: rectal Diclofenac versus Acetaminophen
Rahimi M,Makarem J,Maktobi M
Tehran University Medical Journal , 2009,
Abstract: "nBackground: Anal surgeries are prevalent, but they didn't perform as outpatient surgeries because of concerns about postoperative pain. The aim of the present study was to compare the effects of rectal acetaminophen and diclofenac on postoperative analgesia after anal surgeries in adult patients. "nMethods: In a randomized, double-blinded, placebo-controlled study 60 ASA class I or II scheduled for haemorrhoidectomy, anal fissure or fistula repair, were randomized (with block randomization method) to receive either a single dose of 650 mg rectal acetaminophen (n=20), 100 mg rectal diclofenac (n=20) or placebo suppositories (n=20) after the operation. The severity of pain, time to first request of analgesic agent after administration of suppositories and complications were compared between three groups. Pain scores were evaluated in patients by Visual Analogue Scale (VAS) in 0 (after complete consciousness in recovery), 2, 4, 12 and 24 hours after surgery. The period between administration of the suppositories and the patients' first request to receive analgesic was compared between groups. "nResults: Pain scores were lower significantly in rectal diclofenac than the other groups. The period between administration of the suppositories and the patients' first request to receive analgesic in diclofenac group was 219±73 minutes, was significantly longer compared with placebo (153±47 minutes) and acetaminophen (178±64 minutes) groups. No complications were reported. "nConclusions: Diclofenac suppository is more effective than acetaminophen suppository in post hemorrhoidectomy pain management.
Current Status of Surgical Treatment for Hemorrhoids - Systematic Review and Meta-analysis
Jinn-Shiun Chen,Jeng-Fu You
Chang Gung Medical Journal , 2010,
Abstract: Hemorrhoids are one of the most common anorectal disorders.Conventional hemorrhoidectomy is the most commonlypracticed surgical technique. Stapled hemorrhoidectomy (procedurefor prolapse and hemorrhoids [PPH]) and Ligasurehemorrhoidectomy are newly developed methods for the surgicalmanagement of hemorrhoids. The objective of this studywas to compare the effectiveness and safety of these two noveltechniques with that of conventional hemorrhoidectomy. Fromthe MEDLINE data-base, we obtained papers publishedbetween January 2000 and September 2009 and retrospectivelystudied randomized, controlled clinical trials that comparedPPH versus conventional hemorrhoidectomy or Ligasure hemorrhoidectomyversus conventional hemorrhoidectomy. BothPPH and Ligasure hemorrhoidectomy were superior to conventionalhemorrhoidectomy with regard to operation time, earlypostoperative pain, urinary retention, and time to return to normal activity. However, skintags and recurrent prolapse occurred at higher rates in the PPH group. Although both newtechniques have short-term benefits, especially in reducing extreme postoperative pain, morepowerful clinical studies with long-term follow up and larger sample sizes should be conductedfor further evaluation of outcomes.
Evaluación de la analgesia acupuntural en pacientes operados de hemorroides
Lobaina Acosta,Cipriano; Cuti?o Clavel,Ileana;
MEDISAN , 2012,
Abstract: a therapeutic clinical trial was carried out in 120 patients operated on for hemorrhoids at the coloproctology department of "juan bruno zayas alfonso" general teaching hospital of santiago de cuba, from january to june 2007, to evaluate the effectiveness of the acupuncture analgesia. the case material was divided into 2 groups with 60 members each, who were treated in the most critical moment of pain with conventional western and acupuncture analgesia, respectively. the results were validated through spss version 11.5, by means of mann whitney hypothesis and means comparison tests with a significance level lower than 0.05. in both groups pain assessment was performed at 30 and 60 minutes, with more effectiveness in the last time and in those treated with acupuncture. also, analgesia was achieved with longer durability and no adverse reactions.
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