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At least 397 records · Page 22Linked to original sources
PubMed1989

Rubber band ligation of hemorrhoids and rectal mucosal prolapse in constipated patients.

Rubber band ligation was used in 160 patients with internal hemorrhoids; 43 of them also had rectal anterior mucosal prolapse; 13 had prolapse alone. Two thirds of the patients underwent a single rubber band ligation and one third a double rubber band ligation in one session without anesthesia. Ninety-four required repeated ligations. A follow-up of 25 +/- 16 months (mean +/- SD) was carried out in 153 of them. Rubber band ligation was followed by prolonged bleeding in six patients and severe pain requiring removal of the rubber band in 12 patients. The complication rate decreased significantly (P less than .05) in the last 80 patients. Compared with multiple ligation, single rubber band ligation in one sitting was followed by a lower complication rate (P less than .01). Long-term results were good in 71 percent of the patients. (A formal hemorrhoidectomy was needed within two years in 6 percent.) A significantly lower recurrence rate of 9 percent was noted in those with normal bowel habits, when compared with constipated subjects whose symptoms recurred in 85 percent (P less than .001). Constipation seems to be a predictable factor in worsening the outcome of rubber band ligation. Rubber band ligation is followed by a lower complication rate when performed in a single ligation.

Constipation↗
PubMedDate not supplied

Bacteremia after proctoscopy and hemorrhoidal injection sclerotherapy.

The incidence of bacteremia following proctoscopy and hemorrhoidal injection sclerotherapy was studied in 50 outpatients undergoing both procedures. Bacteremia was found in 2 per cent of the subjects after proctoscopy and in 8 per cent after sclerotherapy. None of the subjects developed symptoms of septicemia following the procedure. It is concluded that antibiotic prophylaxis should be used before sclerotherapy in patients with valvular heart disease or compromised host defense.

Adult↗
PubMed1980

Long-term evaluation of rubber ring ligation in hemorrhoidal disease.

Records of 266 patients who had undergone rubber ring ligation for hemorrhoidal complaints from 1969 through 1976 were reviewed to evaluate the long-term results. The minimum follow-up period was 36 months, with a mean of 60 months. Of the patients, 80 per cent were improved, with 69 per cent totally free of all symptoms. A subsequent hemorrhoidectomy was required in 7.5 per cent. Results were similar when either bleeding or prolapse was the primary indication for treatment. Patients who had a single band applied fared as well as those with two or more ligations.

Adult↗
PubMed1998

[Country-wide survey of therapeutic procedures in hemorrhoids and anal fissure].

A survey among coloproctologists was performed to assess current therapeutic concepts for the treatment of hemorrhoidal disease and anal fissure. A total of 261 clinical and non-clinical proctologists participated, representing the entire range of therapies in hospital and practise. A wealth of widely differing, in some aspects contradictory concepts were recorded, leaving almost no subject entirely undisputed. There are controversies regarding the different therapeutic alternatives as well as indications for surgery and choice of operative procedure. Future research has to address the existing controversies in order to reach a higher degree of standardization in the therapy of these common proctological disorders.

Colorectal Surgery↗
PubMed2003

Hemorrhoidal stapler prolapsectomy vs. Milligan-Morgan hemorrhoidectomy: a long-term randomized trial.

BACKGROUND AND AIMS: The notable success of stapled prolapsectomy in recent years led us to compare this technique with Milligan-Morgan hemorrhoidectomy in terms of the results obtained both in the immediate postoperative period and in the long term. PATIENTS AND METHODS: We performed conventional hemorrhoidectomy on 50 randomly selected patients and operated on a further 50 using the stapler technique. The patients were monitored over the immediate postoperative period (e.g., type of anesthesia, mean duration of operation, mean hospitalization time, analgesic administration, time before returning to work) and over a long-term follow-up period of 48 months (later complications such as prolapse relapse, bleeding, stenosis, incontinence). RESULTS: The stapled group experienced significantly less pain (mean number of analgesic tablets 2.60 vs. 15.9) and returned to normal activity sooner (8.04 vs. 16.9 days), as reported by other authors. In the long-term follow-up at 48 months, stapled hemorrhoidectomy was found to control prolapse, discharge, and bleeding, with no stenosis or significant incontinence, in 94% of cases. CONCLUSION: Our conclusions confirm the excellent advantages of stapled hemorrhoidectomy which allows the rapid recovery of patients and also promises the complete resolution of hemorrhoidal prolapse in the long term.

Activities of Daily Living↗
PubMed2005

The safety and efficacy of stapled hemorrhoidectomy in the treatment of hemorrhoids: a systematic review and meta-analysis of ten randomized control trials.

AIMS: The objective of this study was to compare the safety and efficacy outcomes of stapled hemorrhoidectomy (PPH) with Milligan-Morgan hemorrhoidectomy (MMH) in the treatment of severe hemorrhoids. METHODS: A meta-analysis pooled the effects of the safety and efficacy outcomes on PPH, and MMH in ten randomized control trials was presented using a fixed effects model or a random effects model (via RevMan Version 4.2). RESULTS: There was reasonably clear evidence in favor of PPH for operating time, length of hospital stay, pain, anal discharge, and patient satisfaction. However, skin tags and prolapse occurred at higher rates in the PPH group. PPH was not more superior than MMH as to postoperative bleeding, urinary retention, difficulty in defecating, anal fissure and stenosis, sphincter damage, resumption of normal activities, incontinence, pruritus, anal resting and squeeze pressures, and analgesia. CONCLUSIONS: PPH may be at least as safe as MMH. However, the efficacy of PPH compared with MMH could not be determined absolutely. More rigorous studies with longer follow-up periods and larger sample sizes need to be conducted.

Digestive System Surgical Procedures↗
PubMed2005

Bleeding prolapsed hemorrhoids as a presentation of ruptured internal iliac artery aneurysm: report of a case.

Internal iliac artery aneurysms (IIAAs) are rare and their concealed location in the pelvis presents a diagnostic challenge. We report a case of a 79-year-old man who presented 12 years after an abdominal aortic aneurysm repair, with signs of prolapse, bleeding, hemorrhoids, and a deep vein thrombosis. His condition rapidly deteriorated, with the development of acute renal failure and obvious perianal and perineal ecchymoses, within a few days. Abdominal ultrasound and computed tomography showed a ruptured IIAA. His renal function returned to normal after surgical decompression of the aneurysm.

Aged↗
PubMed2004

[Surgical treatment of hemorrhoids].

The spectrum of procedures for hemorrhoidal disease can deal with all developmental stages if carried out in a differential way. Stapled hemorrhoidopexy is an effective supplement to actual conventional surgical procedures. Hemorrhoidectomies performed with the stapler were compared with segmental hemorrhoridectomies according to Milligan-Morgan as well as anoplasty according to Fansler-Arnold, and proved to be superior as regards complication rate, need for analgesics and operation time, stay in hospital and time off work. But despite the justified euphoria about this innovative method, its necessary limitations should not be disregarded.

Follow-Up Studies↗
PubMed1978

Modified Buie amputation for extensive hemorrhoidal disease.

Radical anal surgery of the type described for complicated hemorrhoidal and mucosal prolapse has good to excellent anatomic and functional results in 90 per cent of patients. This has been demonstrated in a group of 100 consecutive patients followed for an average of more than two years.

Adult↗
PubMed1986

Hemorrhoids or rectal varices: defining the cause of massive rectal hemorrhage in patients with portal hypertension.

Identifying the source of lower gastrointestinal hemorrhage in patients with chronic liver disease and portal hypertension can be challenging. We present 2 cases of hemorrhage from rectal varices and a discussion on the differences between simple hemorrhoids and rectal varices. Evaluation of rectal bleeding in patients with portal hypertension is discussed and possible therapeutic options are described.

Adult↗
PubMed2002

Initial experience with stapled anoplasty in the operative management of prolapsing hemorrhoids and mucosal rectal prolapse.

BACKGROUND: Excisional hemorrhoidectomy has remained the standard procedure in the operative management of hemorrhoids. Innovations in surgical technique have recently been introduced to try to decrease the pain associated with it. Stapled anoplasty has had promising early results in this regard. The aim of this study was to determine the ease or difficulty in introducing this new procedure, its efficacy, safety, and pain profile. DATA SOURCES: Nineteen patients underwent stapled anoplasty and were followed up from 8 weeks to 6 months postoperatively. Data were accrued through clinical evaluation and patient questionnaires. CONCLUSIONS: Seventy-two percent of patients had good to excellent results. There were no significant complications. Eighteen patients underwent surgery in an ambulatory setting and were discharged from hospital in a mean of 189 minutes. The procedure is safe and easily mastered. The staple line should be placed precisely at 3.5 to 4 cm from the dentate line to ensure greater efficacy.

Adult↗
PubMed1994

Hemorrhoids, fissures, and pruritus ani.

The diagnosis and management of hemorrhoids, fissures, and pruritus ani probably accounts for more than 81% of the complaints centered on this part of the human anatomy. This brief treatise offers a safe and practical approach to the management of these three diseases.

Fissure in Ano↗
PubMed1995

Hemorrhoids, anal fissure, and carcinoma of the colon, rectum, and anus during pregnancy.

The pregnant patient afflicted with a variety of colorectal conditions merits special consideration for reasons related to the safety and timeliness of operation while preserving fetal viability and fertility. The literature is scanty with respect to hemorrhoids, fissures, and colorectal and anal carcinoma. Therefore, the patient has to have a forthright discussion with her physician(s) about the pros and cons of operative and nonoperative approaches, which can result in either therapeutic abortion and timely surgery versus preserving the fetus and taking on the unknown factor of whether delay in treatment will cause an adverse outcome. This underscores the need for a frank discussion with the patient with regard to anticipated outcomes. In benign conditions, there is more latitude to adopt a conservative approach, as the patient's ability to tolerate the symptoms of her condition would dictate the need for definitive operative therapy. In the patient with malignancy, delaying surgical or radiation therapy carries an unknown risk to the patient. Here, the patient's personal views regarding abortion and future fertility dictate the timing of definitive treatment.

Adult↗
PubMed1999

Hemorrhoids.

Hemorrhoids are one of the most frequent anorectal disorders encountered in the primary care setting. They are the most common cause of hematochezia, and are responsible for considerable patient suffering and disability. With the techniques of diagnosis and office-based interventions described in this article, the primary care provider can effectively relieve most patients' symptoms and ensure that more significant bowel disease is not overlooked.

Anal Canal↗
PubMedDate not supplied

Radio-ablation of advanced grades of hemorrhoids with radiofrequency.

BACKGROUND: For advanced degree of hemorrhoids with prolapse of the rectal mucosa, the choice is hemorrhoidectomy, which could be open, close, diathermy, Laser, or stapled one. As an effective alternative to this, in situ radio-frequency ablation of the pile mass has been found to be quite efficacious with many added advantages over the conventional hemorrhoidectomy procedures in practice. MATERIALS AND METHODS: This study included 50 patients (34 males and 16 females) treated at Gupta Nursing Home, Laxminagar, Nagpur, India, with the above technique from April 2000 to March 2001 and each case followed up over a period of 12 months. RESULTS: In first 4 weeks of the procedure, 14% of patients complained of bleeding, whereas all of the patients had some amount of pain. Eleven (22%) patients had serosanguinous discharge, but in none of them was there any incontinence or prolapse. All of the patients resumed their routine within 1 week of the procedure. A subsequent follow-up of the patients at an interval of 12 weeks and 12 months showed significant relief in all of the above early postoperative symptoms. During follow-up at the end of 1 year, 7 patients were found to have skin tag formation. However, complications like anal stenosis or stricture or incontinence was not found in any of the patients. CONCLUSION: For advanced degree of piles with prolapse as the main symptom, in situ radio-frequency ablation can be a better choice to various types of hemorrhoidectomy in the sense that the hospital stay is minimized, recurrence is rare, and return to work is faster. The results are more assuring when compared with conventional hemorrhoidectomy. The technique fits into the parameters for being called the gold standard procedure. Except the radio-frequency unit, the procedure needs no specialized instrument. It can be performed in any routine surgical setup.

Catheter Ablation↗
PubMed2003

Constipation, diarrhea, and symptomatic hemorrhoids during pregnancy.

Constipation, diarrhea, and symptomatic hemorrhoids are disorders common in the general population, particularly in women. These conditions, if mild, often are self-treated with various home remedies or nonprescription preparations. Few of these patients, moreover, are referred to gastroenterologists, as primary care providers generally are confident managing these conditions, unless they are severe, refractory to conventional management, or require additional diagnostic studies.

Constipation↗