scholarly journals Efficacy of Harmonic US and LigaSure in Surgical Treatment of 3rd and 4th Degree Internal Hemorrhoids versus Conventional Hemorrhoidectomy

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Mohamed Aly Elhorbity ◽  
Mohamed Ibrahim Mansour ◽  
Nady Ahmed Mahmoud
Keyword(s):  
Surgical Treatment ◽  
Conventional Hemorrhoidectomy ◽  
Internal Hemorrhoids

scholarly journals Anorectal diseases in patients with Antiphospholipid syndrome: a cross-sectional study

2020 ◽  
Vol 60 (1) ◽  
Author(s):  
E. Cunha ◽  
V. Guzela ◽  
G. G. M. Balbi ◽  
C. Sobrado ◽  
D. Andrade
Keyword(s):  
Surgical Treatment ◽  
Antiphospholipid Syndrome ◽  
Clinical Manifestations ◽  
Warfarin Dose ◽  
The United States ◽  
Bivariate Analysis ◽  
Cross Sectional ◽  
Significance Level ◽  
Anal Bleeding ◽  
Internal Hemorrhoids

Abstract Background Hemorrhoid disease (HD) is one of the most common gastrointestinal complaints worldwide, affecting 4.4% of the general population in the United States. Since antiphospholipid syndrome (APS) may lead to intra-abdominal thrombosis, one may expect that this condition can impact the risk for HD development. Additionally, as APS patients are more prone to thrombosis and treatment with anticoagulants may increase risk of bleeding, one may also infer that rates of HD complications may be higher in this scenario. Nevertheless, no data in these regards have been published until now. The objective of the present study is to evaluate frequency of HD and describe its complications rates in antiphospholipid syndrome APS patients. Methods We consecutively invited patients who fulfilled APS criteria to undergo proctological examination. After examination, patients were divided in two groups, based on the presence of HD, and compared regarding different clinical manifestations and antiphospholipid profile. We performed the analysis of the data, using chi-square and Mann Whitney U when applicable and considering a significance level of 0.05. Multivariate regression analysis included age and variables with p < 0.10 in the bivariate analysis. Results Forty-one APS patients agreed to undergo proctological examination. All were female and overall median age was 43 (36–49). Seventeen (41.4%) patients were diagnosed with HD, with the following frequency distribution: 7 internal (41.2%), 4 external (23.5%) and 5 mixed hemorrhoids (29.4%). Of the internal hemorrhoids, 5 patients were classified as grade I (71.4%), 1 grade II (14.3%), and 1 grade IV (14.3%). Prior gestation (p = 0.067) and constipation (p = 0.067) correlated with a higher frequency of HD. In multivariate analysis, constipation remained as an important risk factor (OR 3.92,CI95% 1.03–14.2,p = 0.037). Five out of 17 patients (29.4%) reported anal bleeding, but it did not correlate with warfarin dose (p = 0.949). Surgical treatment was indicated for 10 patients (58.8%). Other anorectal findings were anal fissure, plicoma, condyloma and one chlamydial retitis. Conclusion We found an unexpected high frequency of hemorrhoids in APS patients, with a great proportion requiring surgical treatment.

scholarly journals Effectiveness of Endoscopic Sclerotherapy with Aluminum Potassium Sulfate and Tannic Acid as a Non-Surgical Treatment for Internal Hemorrhoids

2019 ◽  
Vol 52 (6) ◽  
pp. 581-587 ◽  
Author(s):  
Yuichi Tomiki ◽  
Jun Aoki ◽  
Shunsuke Motegi ◽  
Rina Takahashi ◽  
Toshiaki Hagiwara ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Tannic Acid ◽  
Potassium Sulfate ◽  
Endoscopic Sclerotherapy ◽  
Internal Hemorrhoids ◽  
Non Surgical Treatment

EVALUATION THE SURGICAL TREATMENT OF HEMORRHOID DISEASE BY TRANSANAL HEMORRHOIDAL DEARTERIALISATION (THD)

2013 ◽  
pp. 76-82
Author(s):  
Van Lieu Nguyen ◽  
Doan Van Phu Nguyen ◽  
Thanh Phuc Nguyen
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Hospital Stay ◽  
Mucosal Prolapse ◽  
Safe Procedure ◽  
Average Hospital ◽  
Rectal Mucosal Prolapse ◽  
Internal Hemorrhoids ◽  
Grade Iii

Introduction: Since 2006 Transanal hemorrhoidal dearterialization (THD), as a Doppler - guided Minimally Invasive Therapeutic Approach to Hemorrhoids, has been widely applied in European countries, America owing to its remarkable advantages over other surgical procedures such as less postoperative pain, shorter length of hospital stay, absence of serious complications, sooner recovery after surgery. Therefore, it has been widely indicated and accepted by surgeons. In Hue, THD has been implemented since April 2013. So far, this procedure has been in more or less common use to treat grade III and IV internal hemorrhoids with or without rectal mucosal prolapse. Method: From April 2013 through September 2013, 79 patients with grade III and IV hemorrhoids with or without rectal mucosal prolapse were treated by means of THD. During the study, postoperative complications, pains, hospital stay and patient’s satisfaction were monitored. Systematic follow-up of patients after surgery were carried out regularly 1 month and 3 months after surgery. Results: With 79 patients with grade III and IV hemorrhoids with or without rectal mucosal prolapse treated with THD, the following results were obtained: (i) THD was performed on 48 (60.8%) male patients, 31 (39.2%) female patients, mean age of 48.7±22.5 years; the youngest 18 and oldest 81 years old; (ii) Average hospital stay was 2.12 ± 1.25 days, the shortest stay 1 day and the longest 5 days. No surgical complications was reported. No serious postoperative complications was reported; (iii) Postoperative pains were found mild in 65 patients (82.2%), moderate in 13 patients (16.5%), and severe in 1 patient (1.3%). No case of postoperative urinary retention was recorded; (iv) Follow-up 1 month after surgery: good results in 71 patients (94.6%) patients, satisfactory results in 4 patients (5.4%) patients; (v) Follow-up 3 months after surgery: good results in 40 (95.2%) patients, satisfactory results in 2 patients (4.8%). Conclusion: Our research shows that surgical treatment of hemorrhoids with THD proves to be a safe procedure, causing less postoperative pains, shorter hospital stay and sooner resumption of work. Key words: Hemorrhoid disease, transanal hemorrhoidal dearterialisation (THD).

Combined minimally invasive surgical treatment of chronic internal hemorrhoids

2020 ◽  
pp. 76-83
Author(s):  
S. Egupov ◽  
G. Rodoman
Keyword(s):  
Minimally Invasive Surgery ◽  
Surgical Treatment ◽  
Surgical Technique ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Long Term Results ◽  
Minimally Invasive Surgical ◽  
Surgical Methods ◽  
Internal Hemorrhoids ◽  
Minimally Invasive Surgical Treatment

This article is devoted to the results of applying the original minimally invasive surgical technique for the treatment of chronic internal hemorrhoids. The purpose of the study is to improve the outcomes of treatment in patients with chronic internal hemorrhoids by the simultaneous use of pathogenically substantiated low-traumatic surgical methods: dearterialization of internal hemorrhoids with Doppler guidance and clamping with latex rings. Materials and methods. Study included 204 patients with chronic hemorrhoids of the II–III degree, divided into 3 groups depending on the technique of minimally invasive surgery. The standard research methods for coloproctology were used. Results. It was found that the best short-term and long-term results of the surgical treatment of chronic internal hemorrhoids were obtained using the combined surgical technique proposed by the authors. Conclusions. The proposed combination of minimally invasive surgery may be the method of choice in the surgical treatment of chronic hemorrhoids of the II–III degree.

The Management of Acute Hemorrhoidal Disease

2020 ◽  
Vol 15 ◽  
Author(s):  
Lucio Selvaggi ◽  
Guido Sciaudone ◽  
Silvestro Canonico ◽  
Francesco Selvaggi ◽  
Gianluca Pellino
Keyword(s):  
Surgical Treatment ◽  
Conservative Management ◽  
Surgical Intervention ◽  
Hemorrhoidal Disease ◽  
Psychological Effects ◽  
Internal Hemorrhoids ◽  
Prolonged Recovery

: The acute strangulation of internal hemorrhoids and the thrombosis of external hemorrhoids are both debilitating and painful conditions which require immediate treatment in order to minimize morbidity and reduce the length of inactivity. In selected cases, urgent surgical treatment, performed within 72 hours of presentation, prevents the negative economic and psychological effects of a prolonged recovery (which is often the case of conservative management), and limits the necessity for surgical intervention at a later date.

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

Human Stapes Crura: Normal Ultrastructure. Scanning Electron Microscopic Findings

1975 ◽  
Vol 33 ◽  
pp. 528-529
Author(s):  
M.D. Graham
Keyword(s):  
Electron Microscope ◽  
Surgical Treatment ◽  
Scanning Electron Microscope ◽  
Osmic Acid ◽  
Human Cadaver ◽  
Electron Microscopic ◽  
Scanning Electron Microscopic ◽  
Normal Human ◽  
Microscopic Findings ◽  
Scanning Electron

The recent development of the scanning electron microscope has added great impetus to the study of ultrastructural details of normal human ossicles. A thorough description of the ultrastructure of the human ossicles is required in order to determine changes associated with disease processes following medical or surgical treatment.Human stapes crura were obtained at the time of surgery for clinical otosclerosis and from human cadaver material. The specimens to be examined by the scanning electron microscope were fixed immediately in the operating room in a cold phosphate buffered 2% gluteraldehyde solution, washed with Ringers, post fixed in cold 1% osmic acid and dehydrated in graded alcohol. Specimens were transferred from alcohol to a series of increasing concentrations of ethyl alcohol and amyl acetate. The tissue was then critical point dried, secured to aluminum stubs and coated with gold, approximately 150A thick on a rotating stage in a vacuum evaporator. The specimens were then studied with the Kent-Cambridge S4-10 Scanning Electron Microscope at an accelerating voltage of 20KV.

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