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At least 289 records · Page 16Linked to original sources
PubMed1994

Management of hemorrhoids by rubber band ligation.

This study discusses the management of hemorrhoids by rubber band ligation. It reviews 233 rubber band ligation procedures in 148 patients with symptomatic hemorrhoids performed over a 5-year period. 72% of the patients underwent a single rubber band ligation, 22% a double band ligation and 6% a triple band ligation in one session without anesthesia. A follow-up of 18 +/- 5 months was carried out. Only three patients required hospitalization for complications. One patient was admitted for bleeding and recovered with clot evacuation, bed rest and blood transfusion. Two patients developed a band related abscess that resolved with drainage. Twenty patients (13.5%) reported pain associated with the procedure. Four patients needed subsequent surgical hemorrhoidectomy. Long-term results were good in 81.2% of the patients. This report agrees with previously published series showing the efficacy and cost containment of hemorrhoidal ligation.

Adult↗
PubMed1993

[The outpatient management of internal hemorrhoids by infrared photocoagulation].

Infrared photocoagulation is a new ambulatory therapy for 1st, 2nd and 3rd degree internal hemorrhoids. It is an effective method, comparable to others such as sclerotherapy or rubber band ligature. It is necessary to use multiple applications in several sessions in order to obtain good results. Patients with hemorrhoids grade IV are candidates for hemorrhoidectomy. The author did not observe minor nor serious complications with this new therapeutic modality. It is fast and easy to use by a single operator. The equipment is portable, easy to handle and long lasting, needing little maintenance. The anatomical results suggest that the progression of hemorrhoids and also, probably, surgery are prevented. Long-term follow up is necessary.

Adolescent↗
PubMed1993

[Hemorrhoidal disease: the current status].

Traditional and current concepts, anatomical and physiological mechanisms, causes, classification, clinical manifestations, diagnostic approach, and current therapy of hemorrhoidal disease are reviewed in this article. It is encouraged to use the term hemorrhoidal disease instead of the misused one hemorrhoids.

Hemorrhoids↗
PubMed1993

[Folk medicine agents in the treatment of patients with hemorrhoids].

Folk method on hemorrhoid treatment are outlined. The author emphasizes prevention of exacerbations, inflammation of the hemorrhoidal nodes in rectal tissues by local and general treatment methods including exercise therapy, active way of life. Hypodynamia, sessile way of life may result in exacerbation of hemorrhoids. The author recommends various folk medicine agents, describes their composition, doses.

Baths↗
PubMed1996

Aerobic and anaerobic microbiology of infected hemorrhoids.

OBJECTIVES: To study the aerobic and anaerobic microbiology of infected hemorrhoids. METHODS: Retrospective review of the clinical microbiology records. RESULTS: Aspirates of pus from infected hemorrhoids in 19 patients showed bacterial growth. Anaerobic bacteria only were recovered in six (32%) specimens, aerobic bacteria only in one (5%), and mixed aerobic and anaerobic bacteria in 12 (63%). Sixty-eight isolates were recovered: 39 anaerobes (2.1 isolates per specimen) and 29 aerobes (1.5 per specimen). The predominant anaerobes were Bacteroides sp. (13 isolates, including 10 Bacteroides fragilis groups) and 13 Peptostreptococcus sp. The predominant aerobes were Escherichia coli (7), Proteus sp. (5), group D streptococci (4), and Pseudomonas sp. (3). CONCLUSIONS: This study highlights the polymicrobial nature and predominance of anaerobic bacteria in infected hemorrhoids.

Adolescent↗
PubMed1996

[Rubber band ligation of hemorrhoids. A four-year experience].

The non-surgical approach to hemorrhoidal disease was considered, particularly in relation to the rubber band ligation technique. On the basis of a four-year experience collected on 60 treated patients among 75 observed, cases, indications, results and advantages of the method were outlined. Besides the classic method's applications, two cases were presented in which the technique was applied on the grounds of non typical indications. From the final results the rubber band method represents a good therapeutic option for early degrees of hemorrhoidal disease. Moreover, on the basis of the author's experience, this method is also suitable in appropriately selected cases of advanced hemorrhoidal disease intra-anal mucosal prolapse.

Adult↗
PubMed1976

[Age and transformation dynamics of rectal vains and their alteration during hemorrhoid development].

Section and operative materials in persons of various age groups (108 cases in the norm and 197 cases with hemorrhoids) were investigated. Histometrically and macromicroscopically there were revealed veins of a trabecular structure and cavernous bodies in places of the most numerous contacts of the initial roots of the superior, middle and posterior rectal veins in the submucous base of anal columellas. At different stages of formation of hemorrhoids in various forms of phlebectasis (simple, varicous, and cavernous) most pronounced were histostructural changes in the form of endophlebitis and characteristic hypertrophic-atrophic processes of the media. In the process of varicous phlebectasis and formation of hemorrhoids in the cavernous form the ratio of the venous sinus wall thickness to the diameter of the lumen of the venous sinuses are drastically changed at the expense of enlargement of the latter.

Adolescent↗
PubMed1997

[Rubber band ligation of hemorrhoids. Our experience].

The authors present their series of rubber band ligation of hemorrhoids performed from 1991 to 1994 in the Unità di Colon Proctologia of Modena, that is located in the Second Division of Surgery of the Surgical Department of Modena University. In that period 158 patients were treated. Age range was between 17 and 93 years old, and patients were affected by II and III degree of hemorrhoids. The complications verified were: 14 cases of recurrence (8.8%), 2 cases of severe bleeding, no case of perineal sepsis or urinary retention. Other complications of less importance were 89 cases of pain (56.3%), not severe bleeding in 23.41% of patients. Results show that this method of treatment of hemorrhoids, used by experts, is the first choice treatment of this pathology.

Adolescent↗
PubMed1988

Septic complications of hemorrhoidal banding.

Rubber band ligation is an efficacious and cost-effective alternative to conventional hemorrhoidectomy for symptomatic internal hemorrhoids. Even though the well-recognized complications of bleeding and thrombosis occur infrequently, far more serious septic complications have only recently been described, as evidenced in five of our patients: four cases were serious enough to necessitate surgical intervention, and one patient died. Pain followed by urinary dysfunction with or without toxic symptoms should alert the physician to the probability of localized perianal or systemic sepsis. Acute awareness of these rare but potentially life-threatening complications and immediate aggressive treatment is mandatory if death is to be prevented. Rubber band ligation of internal hemorrhoids need not be abandoned; however, the indications should be clear, the technique mastered, and a close patient follow-up maintained.

Abscess↗
PubMed1993

Treatment of advanced hemorrhoidal disease: a prospective, randomized comparison of cold scalpel vs. contact Nd:YAG laser.

PURPOSE: Recently, laser technology has been advocated for the treatment of hemorrhoids. However, there has been little scientific evaluation of the use of the Nd:YAG laser for excisional treatment of hemorrhoidal disease. The purpose of this study was to perform a prospective randomized study of the Nd:YAG laser vs. scalpel excision, when performing a standard Ferguson-closed hemorrhoidectomy. METHODS: Patients presenting for internal-external hemorrhoidectomy were eligible for study. Hemorrhoidectomies were performed under epidural or caudal blocks. The standard Ferguson closed hemorrhoidectomy technique was used. Data evaluated included: age, sex, estimated blood loss, operative time, postoperative pain scores, postoperative analgesic use, wound healing, and time for return to work. Eighty-six patients were eligible for study (laser, N = 51; scalpel, N = 35). RESULTS: There were no significant differences between the groups, except for a greater degree of wound inflammation and dehiscence at the 10 day postoperative visit for the laser group (laser, 1.7 +/- .2; scalpel, 0.8 +/- .2; P < 0.05, t-test). The use of the Nd:YAG laser added $480 per case; as a result, the treatment cost for the laser group was $15,360 higher than that of the conventional group. CONCLUSION: The results indicate that there are no patient care advantages associated with the use of the Nd:YAG laser for excisional hemorrhoidectomy compared with scalpel excision. As new technology becomes available, surgeons must rigorously assess therapeutic efficacy and cost-benefit ratio before deciding to employ this technology for patient care.

Chronic Disease↗
PubMed1993

Long-term results of large-dose, single-session phenol injection sclerotherapy for hemorrhoids.

PURPOSE: The aim of our study was to assess the medium to long-term outcome following single session large dose injection sclerotherapy for symptomatic hemorrhoids. METHODS: One hundred eighty-nine patients (male = 106, female = 83, median age, 51; range, 20-85 years) were assessed following single-session, large-dose (3 x 5 ml) phenol injection therapy. The most frequent complaint was bleeding (100 percent). RESULTS: At four-year follow-up, 53 patients (28.0 percent) were cured, 26 (13.7 percent) were improved, 35 (18.5 percent) remained unchanged, 59 (31.2 percent) deteriorated, and 16 (8.5 percent) required surgical intervention. Among the patients who were not cured, symptoms were minimal in 50 percent. Sclerotherapy was associated with a reduced incidence of bleeding (P < 0.05) but an increase in difficulty in perineal cleaning was observed (P < 0.05). CONCLUSION: Large-dose, single-session sclerotherapy provides only short-term benefits in the majority of patients with symptomatic hemorrhoids.

Adult↗
PubMed1990

A randomized comparison of infrared photocoagulation with bipolar diathermy for the outpatient treatment of hemorrhoids.

One hundred two patients with symptomatic hemorrhoids were randomized to receive treatment with either infrared photocoagulation (IRPC) or a bipolar diathermy probe (BD). There was no significant difference in complications, number of treatments required (IRPC 1.7 [0.9], BD 1.6 [0.8]). Third-degree hemorrhoids required more treatments than smaller piles. BD has some practical advantages over IRPC but results are similar.

Ambulatory Surgical Procedures↗
PubMed1994

Autonomic dysreflexia resulting from prolapsed hemorrhoids. Report of a case.

PURPOSE: This article reports a case of autonomic dysreflexia associated with hemorrhoidal disease in a patient with high spinal cord lesions and successful treatment by surgical hemorrhoidectomy. METHODS: Following an unsuccessful attempt at conservative treatment which included bulk agents and warm compresses, the patient subsequently underwent three-column, closed surgical hemorrhoidectomy. RESULTS: The patient was symptom free and had normal bowel activity six weeks postoperatively, and five-year follow-up showed no recurrence of the hemorrhoidal prolapse or dysreflexia. CONCLUSION: Carefully controlled hemorrhoidectomy, when conservative measures fail, may be effective in managing autonomic dysreflexia in high spinal cord transection patients when prolapse serves as the stimulus.

Adult↗
PubMed1994

New device for rubber band ligation of hemorrhoids.

We describe a new accessory for rubber band ligation of hemorrhoids. By using the new instrument it is possible to abscind the elastic band applied to the base of the hemorrhoidal node without entailing traumatic interventions. Of a total of 62 elastic ligatures, this device was used in the last 18 procedures, and provided excellent results. This instrument enables the surgeon to carry out the technique in a more accurate way and, if necessary, rectify "dangerous mistakes" that can occur while accomplishing the procedure itself.

Ambulatory Surgical Procedures↗
PubMed1990

A surgical treatment of thrombosed external hemorrhoids.

An anatomically based method for the surgical treatment of thrombosed external hemorrhoids has been described. It involves a circumferential incision over the thrombosed hemorrhoidal sinus and removes the thrombi from involved veins.

Anal Canal↗
PubMed1999

Disposable device and a minimally invasive technique for rubber band ligation of hemorrhoids.

A disposable syringe-like hemorrhoid ligator was invented to simplify the banding procedure for both patient and surgeon. This single-operator ligator, with its own suction mechanism and easy loading features, was designed for use without the need of an assistant or an anoscope. By pointing the ligator directly toward the appropriate site and by measuring the distance from the anal margin using reference markings on the ligator, the bands can be placed accurately in a blind manner inside the rectum for the treatment of symptomatic internal hemorrhoids. Before the band is discharged, rotating the ligator through 180 degrees while applying suction will cause pain and give warning if the application site is not appropriate. In 480 patients treated to date, this technique was found to be well accepted and accurate, and the final results seem to be comparable to other methods of banding.

Disposable Equipment↗
PubMed2001

Surgical treatment of hemorrhoids: prospective, randomized trial comparing closed excisional hemorrhoidectomy and the Harmonic Scalpel technique of excisional hemorrhoidectomy.

PURPOSE: The object of this study was to evaluate technique using the ultrasonically activated scalpel as an alternative to closed hemorrhoidectomy in an unbiased evaluation of this new technology. METHODS: Thirty patients with Grade 2 or 3 symptomatic hemorrhoids were prospectively randomized to undergo closed hemorrhoidectomy assisted by electrocautery or hemorrhoidectomy with the ultrasonically activated scalpel, i.e., the Harmonic Scalpel. We evaluated the difference between techniques in operative time, postoperative pain, incontinence, and quality of life (using the Short Form-36 survey), as well as complications. RESULTS: Mean operative time for closed hemorrhoidectomy with electrocautery was 35.7 +/- 3 minutes; for Harmonic Scalpel patients, it was 31.7 +/- 2 minutes (P < 0.37). There was no statistical difference in operative time for two- or three-column hemorrhoidectomy. There was no significant difference in pain measurements reported on Day 1 (5.8 +/- 0.4 for electrocautery and 5.6 +/- 0.6 for Harmonic Scalpel, P < 0.82). On postoperative Day 7, the difference in pain between groups approached significance, with pain reported as 3.7 +/- 0.3 for electrocautery and 5.1 +/- 0.7 for Harmonic Scalpel(R) (P < 0.06). At six weeks, both groups were pain free. There was a significant decrease in pain between postoperative Days 1 and 7 in the electrocautery patients that was not seen in the Harmonic Scalpel patients. Incontinence measured preoperatively, at postoperative Day 7, and at postoperative Week 6 was similar for both groups and reflected occasional incontinence of gas. When the various items of the Short Form-36 survey were compared, there was no significant difference between posttreatment and preoperative values. There was no difference in the number of complications between patient groups. CONCLUSION: Although the Harmonic Scalpel is an effective tool in the treatment of hemorrhoidal disease, we found no specific advantage in postoperative pain, fecal incontinence, operative time, quality of life, or complications compared with traditional closed hemorrhoidectomy.

Adult↗
PubMed2001

Injection treatment of hemorrhoids in patients with acquired immunodeficiency syndrome.

PURPOSE: Patients with acquired immunodeficiency syndrome are often in poor general physical condition. Diarrhea and bleeding hemorrhoids frequently contribute to the morbidity, and patients with such problems cause an increasing load on many outpatient clinics. METHODS: Twenty-two patients (17 males) with acquired immunodeficiency syndrome had injection treatment for bleeding second-degree to fourth-degree hemorrhoids according to standard outpatient clinic routines. Mean follow-up was 24 months. RESULTS: No complications were recorded. The treatment was successful in all patients, and no hemorrhoidectomy was necessary. Nineteen patients improved after their first injection, whereas 3 patients required two to six weeks repeated treatments to improve. Four subjects with the longer follow-up (4 years) showed an improvement lasting 12 to 18 months and then required one to two treatments per year to stop recurrent bleeding. CONCLUSIONS: Because of their poor general condition and poor wound healing, a conservative approach is preferable to avoid a formal hemorrhoidectomy in patients with acquired immunodeficiency syndrome. Sclerotherapy seems to be an attractive alternative.

Adult↗