Topical Treatment with Bergamot Flavonoid-Based Gel in Post-Surgical Wounds after Hemorrhoidectomy: Preliminary Results

Background: Haemorrhoidal Disease (HD) is a very diffuse anorectal condition that involves a large part of the population, both male and female of every age. Among the several procedures proposed to treat HD, conventional excisional surgery remains one of the most performed, it is characterized by important post-operative pain whose historical knowledge often scare the patients. The pain is mainly related to the anal wounds and the healing speed surely influence the post-operative course. The aim of this study was to evaluate the effect of using Benebeo Gel® on post-operative wound healing after open haemorrhoidectomy. Methods and Results: This was an observational prospective study conducted in the Proctological and Pelvic Floor Clinical Centre (PPFCC) of the University Hospital of Pisa. From April 2019 to January 2020 all the 175 patients aged between 18 and 75 undergone to open hemorrhoidectomy were enrolled. The post-operative follow-up was scheduled as follows: 7 day, 15 day, 22 days and 30 days after surgery. The primary end point was: time taken to get complete wound healing with a re-epithelized tissue. Secondary endpoints were: evaluate post-operative pain using VAS scale, bleeding, discharge and overall patients satisfaction about the procedure and the topical gel. All the patients were instructed to take topical gel by using the cannula provided with the product put it into the finger phalanx and then upon injured area twice a day (once in the morning after defecation and once before sleeping) for 25 days after. The administration of the product begins in 4th post-operative day. The mean post-operative pain at 7 days was 6±2, at 15 days 4±1 at 22 day 3 and at 30 days was 2±1. The mean time to get complete wound healing was 23±4 days. Conclusions: He present study aimed to evaluate the efficacy of a new topical gel mainly composed by bergamot-derived flavonoids and hyaluronic acid in patients treated with excisional hemorrhoidectomy. The results after 2 weeks of treatment seems to be promising with a very good clinical outcome and patient satisfaction within 1 month.

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Comparison of harmonic scalpel versus Milligan Morgan technique in haemorrhoidectomy patients

Journal of the Pakistan Medical Association ◽

10.47391/jpma.03-1303 ◽

2021 ◽

Author(s):

Muhammad Ahmad ◽

Syed Tatheer Abbas ◽

Amna Javaid ◽

Naveed Arshad ◽

Falak Shair

Keyword(s):

Wound Healing ◽

Operative Time ◽

Harmonic Scalpel ◽

Controlled Trial ◽

P Value ◽

Randomized Controlled ◽

Group A ◽

The Mean ◽

Complete Wound Healing ◽

Group B

Objectives: To assess the comparison of harmonic scalpel versus Milligan Morgan technique in patients undergoing haemorrhoidectomy. Methodology: This randomized controlled trial study was conducted at General Hospital, Lahore, from March 2019 to September 2019. Informed consent was obtained from eligible 60 patients. Patients were randomly divided into two equal groups. In group-A, haemorrhoidectomy was conducted according to the harmonic scalpel method. In group-B, open haemorrhoidectomy was performed by the Milligan Morgan procedure. Data was assembled through a designed questionnaire and investigated via SPSS version 25. Data were stratified for descriptive statistics, level of haemorrhoids and period of haemorrhoids. Post-stratification, independent sample t-test was used. Results: Mean age of both groups patients were 44.6±7.6 and 43.8±8.2 years, respectively. In group-A, mean operative time was 20.8±2.8 minutes, while 26.5±2.8 minutes in group-B, which was statistically significant with p-value of 0.001. In group-A, mean convalescence period was 9.7±2.9 days, while 13.4±3.7 days in group-B, which was statistically significant with p-value of 0.001. The mean convalescence period with harmonic scalpel method was 7.4 days (range 5–14, SD 3.6) versus 18.6 days (range 7–30, SD 5.4) with Milligan Morgan technique (P?0.001). This research observed that harmonic scalpel method required almost six weeks for complete wound healing, whereas in Milligan Morgan technique, complete wound healing was achieved after three months (P<0.05). Conclusion: Harmonic scalpel haemorrhoidectomy found an advantageous method when assessing the operative time and convalescence period. Hence, Harmonic scalpel haemorrhoidectomy can be adapted as a safe and effective alternative method for treating symptomatic haemorrhoids. Continuous...

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Short-term Results Of Sclerotherapy With 3% Polidocanol Foam For Symptomatic Second- And Third-degree Haemorrhoidal Disease

10.21203/rs.2.13762/v1 ◽

2019 ◽

Author(s):

Pierluigi Lobascio ◽

Rita Laforgia ◽

Eugenio Novelli Novelli ◽

Fabrizio Perrone ◽

Maria Di Salvo ◽

...

Keyword(s):

Operative Time ◽

Intraoperative Complications ◽

Cost Effective ◽

Daily Activities ◽

Anal Continence ◽

Short Term ◽

Haemorrhoidal Disease ◽

Post Operative Pain ◽

Symptom Scores ◽

The Mean

Abstract Background.Haemorrhoidal disease (HD) is defined as the symptomatic enlargement and/or distal displacement of anal cushions and is one of the most common proctological diseases. Sclerotherapy (ST) with 3% polidocanol foam induces an inflammatory reaction with sclerosis of the submucosal tissue and consequent suspension of the haemorrhoidal tissue. The aim of this study was to evaluate the short-term effectiveness and safety of ST with 3% polidocanol foam for the treatment of symptomatic second- and third-degree HD. Methods.A total of 66 patients with symptomatic second- and third-degree HD underwent a single ST session between March 2017 and July 2018. A visual analogue scale score was used to assess post-operative pain and patient satisfaction. The symptoms severity and anal continence were investigated through a self-reported questionnaire and Vaizey score, respectively, at baseline, at 4 weeks and after 1 year. Results. Fifty-seven out of 66 patients were male (86.3%), and the mean age was 52 (29-75; SD ± 12) years. The mean operative time was 4.5 (2-6; SD ± 1.23) minutes. No intraoperative complications and no drug-related side effects occurred. The overall success rate was 78.8% (52/66 patients) after a single ST session and 86% after two ST sessions (57/66 patients). The mean treatment effect, obtained comparing preoperative and T5 symptom scores in each patient, showed a mean change of 7.88 (p<0.001). All patients resumed their normal daily activities the day after the procedures. Conclusions.ST with 3% polidocanol foam is a safe, cost-effective and repeatable conservative treatment.

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Blood Loss of Scalpel versus Cutting Cautery in Bilateral Reduction Mammoplasty Procedures

Canadian Journal of Plastic Surgery ◽

10.1177/229255039600400402 ◽

1996 ◽

Vol 4 (4) ◽

pp. 1-5

Author(s):

Lawrence N Hurst ◽

Sanjeev Kaila

Keyword(s):

Wound Healing ◽

Adverse Effects ◽

Blood Loss ◽

Confidence Level ◽

Breast Tissue ◽

Reduction Mammoplasty ◽

University Hospital ◽

Postoperative Result ◽

Perioperative Blood Loss ◽

The Mean

Cutting electrocautery may be used for the dissection of breast tissue in bilateral reduction mammoplasty procedures without adverse effects on wound healing. It has been suggested that the use of cutting cautery reduces perioperative blood loss; however, very few studies have been performed to verify this assumption. This study compares the blood loss using cutting cautery with scalpel dissection. The study analyzed the preoperative and one-day postoperative hemoglobin levels of 22 randomly chosen patients dissected with scalpel at University Hospital during 1983, and compared these results with results obtained from 39 randomly chosen patients dissected using cutting cautery in 1993. The results show a difference in the mean postoperative result of 5.77 g/L, which is significant at the 95% confidence level with P>0.03 and P<0.04.

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Short-term Results Of Sclerotherapy With 3% Polidocanol Foam For Symptomatic Second- And Third-degree Haemorrhoidal Disease

10.21203/rs.2.13762/v2 ◽

2019 ◽

Author(s):

Pierluigi Lobascio ◽

Rita Laforgia ◽

Eugenio Novelli Novelli ◽

Fabrizio Perrone ◽

Maria Di Salvo ◽

...

Keyword(s):

Operative Time ◽

Intraoperative Complications ◽

Cost Effective ◽

Daily Activities ◽

Anal Continence ◽

Short Term ◽

Haemorrhoidal Disease ◽

Post Operative Pain ◽

Symptom Scores ◽

The Mean

Abstract Background . Haemorrhoidal disease (HD) is defined as the symptomatic enlargement and/or distal displacement of anal cushions and is one of the most common proctological diseases. Sclerotherapy (ST) with 3% polidocanol foam induces an inflammatory reaction with sclerosis of the submucosal tissue and consequent suspension of the haemorrhoidal tissue. The aim of this study was to evaluate the short-term effectiveness and safety of ST with 3% polidocanol foam for the treatment of symptomatic second- and third-degree HD. Methods . A total of 66 patients with symptomatic second- and third-degree HD underwent a single ST session between March 2017 and July 2018. A visual analogue scale score was used to assess post-operative pain and patient satisfaction. The symptoms severity and anal continence were investigated through the Hemorrhoid Severity Score (HSS) and Vaizey score, respectively, at baseline, at 4 weeks and after 1 year. Results . Fifty-seven out of 66 patients were male (86.3%), and the mean age was 52 (29-75; SD ± 12) years. The mean operative time was 4.5 (2-6; SD ± 1.23) minutes. No intraoperative complications and no drug-related side effects occurred. The overall success rate was 78.8% (52/66 patients) after a single ST session and 86% after two ST sessions (57/66 patients). The mean treatment effect, obtained comparing preoperative and T5 symptom scores in each patient, showed a mean change of 7.88 (p<0.001). All patients resumed their normal daily activities the day after the procedures. Conclusions . ST with 3% polidocanol foam is a safe, cost-effective and repeatable conservative treatment.

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Endoscopic Pilonidal Sinus Treatment: A Tertiary Care Academic Center Experience

Frontiers in Surgery ◽

10.3389/fsurg.2021.723050 ◽

2021 ◽

Vol 8 ◽

Author(s):

Gaetano Gallo ◽

Antonio Carpino ◽

Gilda De Paola ◽

Serena Fulginiti ◽

Eugenio Novelli ◽

...

Keyword(s):

Wound Healing ◽

Pilonidal Sinus ◽

Pilonidal Disease ◽

Tertiary Care ◽

Time To Recurrence ◽

Academic Center ◽

Post Operative Pain ◽

The Mean

Background: Pilonidal disease (PD) represents one of the most common proctological diseases in young adults. Although several approaches to treating PD have been described, there is still a lack of agreement on which is the best. The aim of this study was to evaluate the long-term efficacy of endoscopic pilonidal sinus treatment (EPSiT) at a tertiary care academic center.Methods: Between June 2017 and January 2021, a total of 32 patients [12 women (37.5%) and 20 men (62.5%)] with a mean age of 29.22 ± 12.98 years were treated with EPSiT. Pre- and post-operative symptoms were assessed with a score of 0–5. Success was defined as the absence of any subjective symptoms, as well as by complete post-operative wound healing.Results: Most of the patients had a midline external opening (17/32; 53.1%), with a mean number of external openings of 2.41 (1–4) ± 1.04. The median post-operative pain score was 0, and the mean follow-up period was 22 (4–42) ± 11.49 months. The time to wound healing was reduced in patients with one opening (28.14 ± 4.06 days) compared to patients with two or more openings (33.64 ± 7.3 days) (p = 0.067). The mean operative time was longer in patients who subsequently had a recurrence (41.75 ± 6.24 vs. 34.18 ± 6.24 min; p = 0.031). The overall success rate was 87.5% (28/32), and the mean time to recurrence was 3.25 (2–5) ± 1.26 months.Conclusions: EPSiT represents a viable option for the treatment of PD. More evidence and a longer follow-up period are needed to validate the results.

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OPEN VERSUS CLOSED HEMORRHOIDECTOMY – A COMPARATIVE STUDY

10.36106/gjra/4001626 ◽

2021 ◽

pp. 46-47

Author(s):

Sujeet Kumar Bharti ◽

Kirti Priya

Keyword(s):

Wound Healing ◽

Bleeding Complications ◽

P Value ◽

Operative Outcomes ◽

Open Hemorrhoidectomy ◽

Post Operative Pain ◽

Routine Work ◽

Closed Hemorrhoidectomy ◽

Group B ◽

Open Versus

Background and Objectives: - Hemorrhoids are specialized, highly vascularized cushions within the normal anal canal. Hemorrhoidectomy is considered as an effective treatment for III degree and IV degree hemorrhoids. The conventional Milligan-Morgan open hemorrhoidectomy remains the more commonly performed operation. Ferguson's closed hemorrhoidectomy has gained considerable attention because of the less pain, faster wound healing and better patient compliance. Nonetheless, randomized controlled trials have reported conicting results regarding post-operative outcomes between two methods. Methods: - 60 patients were included in this study, who underwent hemorrhoidectomy, by split them into two equal groups. Group A underwent open hemorrhoidectomy and group B underwent closed hemorrhoidectomy. Patient in each group were studied in terms of post-operative pain, wound healing, bleeding, length of hospital stays and the results were analysed and tested with statistical methods. Results: - In study of 60 cases, peak incidence was found at 46 years of age and more common in males (5.67:1). Difference in pain between the 2 groups was found statistically signicant (P value <0.05). 29 (96/67%) patients had completely healed wound from group B (closed) at 3rd week compared to 5 (16.67%) from group B. 7 (23.3%) patients in closed group had complications, in contrast to 25 (83.3%) in open group. Conclusion: - We got in this study that patients who underwent Ferguson's closed hemorrhoidectomy had less post-operative pain, bleeding, complications, early healing of wound and early back to routine work compared to Milligan-Morgan's open hemorrhoidectomy group

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Mesoglycan for pain control after open excisional HAEMOrrhoidectomy (MeHAEMO): an observational multicentre study on behalf of the Italian Society of Colorectal Surgery (SICCR)

BMC Surgery ◽

10.1186/s12893-020-00914-5 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

G. Gallo ◽

◽

S. Di Saverio ◽

G. Clerico ◽

A . Sturiale ◽

...

Keyword(s):

Wound Healing ◽

Pain Control ◽

Standard Technique ◽

Surgical Wound ◽

Early Recovery ◽

Haemorrhoidal Disease ◽

Post Operative Pain ◽

Group Post ◽

Time Point

Abstract Background Excisional haemorrhoidectomy is the gold standard technique in patients with III and IV degree haemorrhoidal disease (HD). However, it is associated with a significant rate of post-operative pain. The aim of our study was to evaluate the efficacy of mesoglycan in the post-operative period of patients who underwent open excisional diathermy haemorrhoidectomy (OEH). Methods This was a retrospective multicentre observational study. Three hundred ninety-eight patients from sixteen colorectal referral centres who underwent OEH for III and IV HD were enrolled. All patients were followed-up on the first post-operative day (T1) and after 1 week (T2), 3 weeks (T3) and 6 weeks (T4). BMI, habits, SF-12 questionnaire, VAS at rest (VASs), after defecation (VASd), and after anorectal digital examination (VASe), bleeding and thrombosis, time to surgical wound healing and autonomy were evaluated. Results In the mesoglycan group, post-operative thrombosis was significantly reduced at T2 (p < 0.05) and T3 (p < 0.005), and all patients experienced less post-operative pain at each time point (p < 0.001 except for VASe T4 p = 0.003). There were no significant differences between the two groups regarding the time to surgical wound healing or post-operative bleeding. There was an early recovery of autonomy in the mesoglycan group in all three follow-up periods (T2 p = 0.016; T3 p = 0.002; T4 p = 0.007). Conclusions The use of mesoglycan led to a significant reduction in post-operative thrombosis and pain with consequent early resumption of autonomy. Trial registration NCT04481698—Mesoglycan for Pain Control After Open Excisional HAEMOrrhoidectomy (MeHAEMO) https://clinicaltrials.gov/ct2/show/NCT04481698?term=Mesoglycan+for+Pain+Control+After+Open+Excisional+HAEMOrrhoidectomy+%28MeHAEMO%29&draw=2&rank=1

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RESULTS OF THE SUTURE OF THE PERFORATION BY SINGLE-PORT LAPAROSCOPIC SURGERY (SPLS) FOR THE PERFORATED DUODENAL ULCER TREATEMENT

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2014.4_5.18 ◽

2014 ◽

pp. 126-132

Author(s):

Huu Tri Nguyen ◽

Van Lieu Nguyen

Keyword(s):

Duodenal Ulcer ◽

Laparoscopic Surgery ◽

Single Port ◽

Previous History ◽

University Hospital ◽

Safe Procedure ◽

Perforated Duodenal Ulcer ◽

Analgesic Requirement ◽

Duodenal Ulcers ◽

The Mean

Background Single-port laparoscopic surgery (SPLS) was increasingly used on several surgical diseases. The aim of this study is evaluation of the results of the suture of the perforation by SPLS for the perforated duodenal ulcer treatement. Methods From January 2012 to July 2014, 35 patients with perforated duodenal ulcers underwent simple suture of the perforations by SPLS at Hue University Hospital and Hue Central Hospital. Results The mean age was 45.9 ± 14.4 years. The sex ratio (male/female) was 16.5 and the mean of BMI was 19.2 ± 2.3. There was one patient (2.9%) with previous history of laparoscopic repair of perforated duodenal ulcer. The duration of the symptoms was 9.9 ± 12.3 hours. 97.1% of patients had the perforations of the anterior wall of the duodenum. The mean size of the perforation was 4.7 ± 3.4 mm (2 – 22mm). 2.9% of patients had the perforations of the posterior wall of the duodenum. The rate of the conversion to the open surgery was 2.9%. The mean operative time was 75.8 ± 33.7min, and the mean hospital stay was 5.8 ± 1.4 days. The mean of the analgesic requirement time was 2.9 ± 0.8 days. The wound length was 1.9 ± 0.1 cm. There was 5.9% of the patients had wound infection. There was no operation-related mortality. Conclusions Simple suture of the perforation by single-port laparoscopic surgery is a feasible and safe procedure, and it may be a scarless surgical technique for perforated duodenal ulcers treatement. Key words: single-port laparoscopic surgery, perforated duodenal ulcer

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EVALUATION OF LONGO’S HEMORRHOIDECTOMY AT HUE UNIVERSITY HOSPITAL

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2012.6.10 ◽

2012 ◽

pp. 79-85

Author(s):

Van Lieu Nguyen ◽

Doan Van Phu Nguyen ◽

Thanh Phuc Nguyen

Keyword(s):

Hospital Stay ◽

Perioperative Complications ◽

University Hospital ◽

Anal Pain ◽

Stapled Hemorrhoidectomy ◽

Fourth Degree ◽

Duration Of Hospital Stay ◽

The Mean ◽

Good For

Introduction: Since Longo First described it in 1998, Stapled Hemorrhoidectomy has been emerging as the procedure of choice for symtomatic hemorrhoid. Several studies have shown it to be a safe, effective and relative complication free procedure. The aim of this study was to determine the suitability of (SH) as a day cas procedure at Hue University Hospital. Methods: From Decembre 2009 to April 2012, 384 patients with third- degree and fourth-degree hemorrhoids who underwent Stapled Hemorrhoidectomy were included in this study. Parameters recorded included postoperative complications, analegic requirements, duration of hospital stay and patient satisfaction. Follow-up was performed at 1 month and 3 months post-operative. Results: Of the 384 patients that underwent a Stapled Hemorrhoidectomy 252 (65,7%) were male and 132 (34,3%) were female. The mean age was 47,5 years (range 17-76 years. Duration of hospital stay: The mean day was 2,82 ± 1,15 days (range 1-6 days). There were no perioperative complications. There was one case postoperative complication: hemorrhage; Follow-up after surgery: 286 (74,4%) patients had less anal pain, 78 (20,3%) patients had moderate anal pain, 3 (0,8%) patients had urinary retention; Follow-up after one month: good for 325 (84,6%) patients, average for 59 (15,4%) patients; Follow-up after three months: good for 362 (94,3%) patients, average for 22 (5,7%) patients. Conclusion: Our present study shows that Stapled Hemorrhoidectomy is a safe, reduced postoperative pain, shorter hospital stay and a faster return to unrestricted daily activity

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EARLY RESULTS OF SINGLE-PORT LAPAROSCOPIC APPENDECTOMY

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2017.1.16 ◽

2017 ◽

pp. 103-106

Author(s):

Minh Duc Pham

Keyword(s):

Laparoscopic Appendectomy ◽

Single Port ◽

Operation Time ◽

Invasive Procedure ◽

Minimal Invasive ◽

University Hospital ◽

Early Results ◽

Sils Port ◽

The Mean ◽

A New Technique

Background: Conventional three–port laparoscopic appendectomy is becoming popular for the treatment of acute appendicitis. In this report, we present the early results of a new technique of laparoscopic appendectomy conducted through a single-port. Patients and Methods: From March 2011 to October 2013, we have performed 86 operations Single Port Laparoscopic Appendectomy at Hue University Hospital and Hue Central Hospital. SILS Port (Covidien) is used, it can be performed with basic laparoscopic instruments. Results: In this study, 86 patients underwent Single-Port laparoscopic appendectomy, among them 52.33% were femele, 47.67% were male, female/male ratio was 1.09. The mean age was 33.09. An orther trocar insertion was required in 2 patients (2.33%). The mean operation time was 42.03 minutes and mean postoperative hospital stay 3.37 days. Postoperative complication occurred in 2 case (2.33%) was of omphalitis. During 2 weeks follow up, 2 case (2.33%) was of omphalitis. Conclusions: Single - port intracorporeal appendectomy is a safe, minimal invasive procedure with excellent cosmetic results. Key words: Single Port Laparoscopic Appendectomy, appendectomy

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