M1247 Evaluation of Less Invasive Treatments Including Sclerotherapy With Alta and Pph for Prolapsing Internal Hemorrhoids: Comparison With Conventional Hemorrhoidectomy

2010 ◽  
Vol 138 (5) ◽  
pp. S-363
Author(s):  
Yukihiko Tokunaga ◽  
Hirokazu Sasaki ◽  
Tohru Saito
Keyword(s):  
Less Invasive ◽  
Conventional Hemorrhoidectomy ◽  
Internal Hemorrhoids

scholarly journals Impact of Less Invasive Treatments Including Sclerotherapy With a New Agent and Hemorrhoidopexy for Prolapsing Internal Hemorrhoids

2013 ◽  
Vol 98 (3) ◽  
pp. 210-213 ◽  
Author(s):  
Yukihiko Tokunaga ◽  
Hirokazu Sasaki
Keyword(s):  
Postoperative Pain ◽  
Tannic Acid ◽  
Alternative Treatment ◽  
Severe Pain ◽  
Outpatient Basis ◽  
Potassium Sulphate ◽  
Less Invasive ◽  
Pain Medications ◽  
Conventional Hemorrhoidectomy ◽  
Internal Hemorrhoids

Abstract Conventional hemorrhoidectomy is applied for the treatment of prolapsing internal hemorrhoids. Recently, less-invasive treatments such as sclerotherapy using aluminum potassium sulphate/tannic acid (ALTA) and a procedure for prolapse and hemorrhoids (PPH) have been introduced. We compared the results of sclerotherapy with ALTA and an improved type of PPH03 with those of hemorrhoidectomy. Between January 2006 and March 2009, we performed hemorrhoidectomy in 464 patients, ALTA in 940 patients, and PPH in 148 patients with second- and third-degree internal hemorrhoids according to the Goligher's classification. The volume of ALTA injected into a hemorrhoid was 7.3 ± 2.2 (mean ± SD) mL. The duration of the operation was significantly shorter in ALTA (13 ± 2 minutes) than in hemorrhoidectomy (43 ± 5 minutes) or PPH (32 ± 12 minutes). Postoperative pain, requiring intravenous pain medications, occurred in 65 cases (14%) in hemorrhoidectomy, in 16 cases (1.7%) in ALTA, and in 1 case (0.7%) in PPH. The disappearance rates of prolapse were 100% in hemorrhoidectomy, 96% in ALTA, and 98.6% in PPH. ALTA can be performed on an outpatient basis without any severe pain or complication, and PPH is a useful alternative treatment with less pain. Less-invasive treatments are beneficial when performed with care to avoid complications.

scholarly journals Outcome of manual hemorrhoidopexy in the management of hemorrhoids

2014 ◽  
Vol 9 (2) ◽  
pp. 15-19
Author(s):  
Sujit Kumar ◽  
P Kafle ◽  
SJ Shrestha ◽  
S Agrawal ◽  
BN Patowary
Keyword(s):  
Medical Sciences ◽  
Analgesic Requirement ◽  
Conventional Hemorrhoidectomy ◽  
Significant Difference ◽  
Internal Hemorrhoids ◽  
Group A ◽  
Male Patients ◽  
A New Technique ◽  
Group B ◽  
A Prospective Study

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

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