Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “HEMORRHOIDS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,711 records · Page 95Linked to original sources
PubMed1999

Prospective study of healing time after hemorrhoidectomy: influence of HIV infection, acquired immunodeficiency syndrome, and anal wound infection.

PURPOSE: Hemorrhoids and rectal diseases are very frequent in HIV-positive patients, especially in those with homosexual habits. This study was designed to compare posthemorrhoidectomy healing time in such patients, and evaluate the role of various factors related to their HIV-positive status. METHODS: The study involved a prospective series of 48 male patients (32 HIV-seropositive and 16 with acquired immunodeficiency syndrome) who underwent hemorrhoidectomy between 1992 and 1996; 20 age-matched and gender-matched seronegative patients were retrospectively identified as controls. Healing times, postoperative complications, and wound infections were recorded, and the delaying effect of CD4+, Karnofsky Index scores, and HIV-ribonucleic acid were evaluated. Between-group differences were analyzed using Cox's model, Student's t-test, chi-squared test, and Fisher's exact probability test. P values of <0.05 were considered statistically significant. RESULTS: Cox's model revealed that HIV positivity and the presence of acquired immunodeficiency syndrome significantly delayed wound healing, which also correlated with the presence of infection. The healing rate in HIV-positive patients was 66 percent after 14 weeks and 100 percent after 32 weeks; the corresponding figures for patients with acquired immunodeficiency syndrome were 0 and 50 percent. All of the controls were healed after 14 weeks (P < 0.01 vs. both the patients with acquired immunodeficiency syndrome and HIV+ patients). Centers for Disease Control and Prevention HIV-positive status (including CD4+ counts) and the performance status proved to be of prognostic value. CONCLUSIONS: Our data suggest that the indications for hemorrhoidectomy in patients with acquired immunodeficiency syndrome need to be considered extremely carefully because of the high incidence of delayed wound healing.

Acquired Immunodeficiency Syndrome↗
PubMed1984

Results of Whitehead operation.

Eighty-four patients underwent the Whitehead procedure for extensive hemorrhoids. Early postoperative complications, excluding urinary difficulties, developed in six patients. Long-term results were within an acceptable range.

Adult↗
PubMed1983

Long-term follow-up of closed hemorrhoidectomy.

Four hundred forty-one patients who had closed hemorrhoidectomy with local anesthesia were followed for one to seven years postoperatively to assess long-term results and patient satisfaction. Seven and one-half per cent needed further treatment of hemorrhoids, 7.7 per cent developed other anorectal or colonic pathology, and 0.5 per cent had lasting incontinence. Lateral internal sphincterotomy did not predispose to incontinence. Patient satisfaction was 92.6 per cent.

Adolescent↗
PubMed1986

Rectal bleeding induced by Dipyridamole.

Nineteen patients treated continuously with Dipyridamole were evaluated for rectal bleeding. Thirteen suffered from overt rectal bleeding and six served as controls. Hemorrhoids were found in all patients. Contact bleeding was found in 16. The bleeding continued despite rubber band ligation, and stopped only on withdrawal of the drug.

Dipyridamole↗
PubMed1984

Epidural morphine for post-hemorrhoidectomy analgesia.

Sixty-six patients were operated upon for third- or fourth-degree hemorrhoids during the period of January 1982 through November 1983. A single injection of epidural morphine was given for relief of postoperative pain. Eighty-three point three per cent of the patients needed no other analgesics and 16.7 per cent required only mild analgesics. There were no complications observed after surgery.

Adult↗
PubMed1984

Surgical treatment of chronic anal fissure. A retrospective study of 1753 cases.

This is a retrospective study of 1753 cases of chronic anal fissures treated by five varying methods over a five-year period from January 1976 to December 1980. Results showed that the incidence of recurrent fissures was higher in those treated by anal fissurectomy with sphincterotomy. There was also a significant difference in operative time, length of hospital stay, patient discomfort, and incidence of urinary retention among these operative methods. Generally, lateral anal sphincterotomy and multiple anal sphincterotomies showed a lesser incidence of these factors. A simpler procedure, such as lateral anal sphincterotomy or multiple anal sphincterotomies, is the treatment of choice for chronic anal fissure. However, a chronic anal fissure associated with symptomatic enlarged hemorrhoids may have a similar result when treated with hemorrhoidectomy and fissurectomy as a combined procedure.

Adult↗
PubMed1988

The Whitehead hemorrhoidectomy. An unjustly maligned procedure.

The Whitehead technique of hemorrhoidectomy has developed a reputation as an undesirable procedure since its description in 1882. The chief criticisms have been considerable blood loss, disturbance of continence, formation of an ectropion, and poor healing of the mucocutaneous junction followed by stricture formation. Five hundred fifty-six patients underwent a modified Whitehead hemorrhoidectomy, performed by one author (C.E.C.), between 1963 and 1983. Seventy-two of these patients had unclaimed follow-up letters, leaving 484 patients available for review. Four hundred forty of these patients were followed for over three years. Postoperative complications included fistula or abscess in 1.1 percent, flap loss in 6.9 percent, and a nonhealing wound in one patient. There were no recurrences and there was no ectropion formation, or "Whitehead deformity." Mortality was zero and total morbidity, including 7.2 percent flap detachment, was 12.2%. A modified Whitehead technique has become the authors' procedure of choice for circumferential prolapsing and bleeding hemorrhoids and mucosa.

England↗
PubMed1977

Hemorrhoidectomy--how I do it: current views in Britain.

It is clear that there is no uniform treatment for hemorrhoids in Britain. Indeed, there is often considerable debate about the merits and disadvantages of the various methods available. It would seem that a more scientific way of assessing the management of patients is needed so that the various therapeutic measures may be properly evaluated, comparing like with like. It may then be possible to tailor the treatment for each individual more accurately, in order to confer the maximum benefit.

Cryosurgery↗
PubMed1977

Hemorrhoidectomy--how I do it: results of 444 cryorectal surgical operations.

Based on a three-year personal experience with a large number of patients, cryorectal surgery is a reliable and valuable alternative to excision for the removal of all types of hemorrhoids and most other concomitant pathologic conditions found in 44% of these patients. Excellent results should be anticipated, and complications are minimal. No contraindication has yet been detected.

Cryosurgery↗
PubMed1982

Preserving Treitz's muscle in hemorrhoidectomy.

A new, improved approach to closed and semiclosed hemorrhoidectomy is described, in which the amount of excision is reduced. The operation has evolved from refinement of the excision and ligation technique, which may be considered too extensive a procedure. Treitz's muscle, lying on, penetrating in, and surrounding the internal and sphincter, is considered normal function tissue and is not excised. Its preservation permits easy approximation and suture of the wound edges to their normal, supple underlying tissue, avoiding direct fixation to the more rigid internal and sphincter. Residual hemorrhoidal tissue beneath the edges, if present, is also sewed to Treitz's fibromuscular tissue. Flat closed and semiclosed wounds with normal supple folding and without narrowing of the anal canal result. In a consecutive series of 100 patients, primary healing was observed in 80 per cent of the patients. Sixty four per cent experienced no pain on defecation. The functional result, with a normally pliant anorectal lining and anchorage to the preserved Treitz's muscle, is excellent. The procedure represents an accurate reconstruction of a normal state with respect to anatomy and function.

Adult↗
PubMed2004

[Retroperitoneal hematoma due to seam insufficiency after stapled hemorrhoidectomy].

Stapled hemorrhoidectomy (circumferential mucosectomy) is a technique for the surgical management of third- to fourth-degree hemorrhoids. It is a quick, simple, and painless technique. Complications are endoluminal bleeding, anal stenoses, fistulas, and incontinence. This case report deals with a severe complication which has not been described yet. Our patient had anemic, retroperitoneal bleeding with consecutive evacuation of the hematoma through the stapler anastomosis and following several operations. Nevertheless, a temporary colostomy was not necessary. As mentioned in other publications describing complications after stapled hemorrhoidectomy, this new technique should be used carefully and by surgeons with experience.

Anastomosis, Surgical↗
PubMedDate not supplied

Portal vein absence and nodular regenerative hyperplasia of the liver with giant inferior mesenteric vein.

We present a patient with nodular regenerative hyperplasia of the liver (NRH) and portal vein absence studied with CT, MR imaging, and MR angiography. The most striking feature was exuberant hemorrhoids due to a giant hepatofugal inferior mesenteric vein. A relationship between unbalanced portal blood flow and nodular regenerative transformation of the liver is suggested in this patient.

Adolescent↗
PubMed2003

Stapled and open hemorrhoidectomy: randomized controlled trial of early results.

The aim of the study was to compare the early results in 52 patients randomly allocated to undergo either stapled or open hemorrhoidectomy. Seventy-four patients with grade III and IV hemorrhoids were randomly allocated to undergo either stapled (37 patients) or open (37 patients) hemorrhoidectomy. Stapled hemorrhoidectomy was performed with the use of a circular stapling device. Open hemorrhoidectomy was accomplished according to the Milligan-Morgan technique. Postoperative pain was assessed by means of a visual analogue scale (V.A.S.). Recovery evaluation included return to pain-free defecation and normal activities. A 6-month clinical follow-up and a 17.5 (10 to 27)-month median telephone follow-up was obtained in all patients. Operation time for stapled hemorrhoidectomy was shorter (median 25 [range 15 to 49] minutes versus 30 [range 20 to 44] minutes, p = 0.041). Median (range) V.A.S. scores in the stapled group were significantly lower (V.A.S. score after 4 hours: 4 [2 to 6] versus 5 [2 to 8], p = 0.001; V.A.S. score after 24 hours: 3 [1 to 6] versus 5 [3 to 7], p = 0.000; V.A.S. score after first defecation: 5 [3 to 8] versus 7 [3 to 9], p = 0.000). Resumption of pain-free defecation was significantly faster in the stapled group (10 [6 to 14] days vs 12 [9 to 19] days, p = 0.001). At follow-up 4 weeks and 6 months postoperatively the median (range) symptom severity score was similar in both groups (1 [0 to 2] versus 0 [0 to 3], p = 0.150 and 0 [0 to 2] versus 0 [0 to 2], p = 0.731). At long-term follow-up occasional pain was present in 6/37 (16.2) patients in the stapled group and 7/37 (18.9%) in the Milligan-Morgan group (p = 1.000); episodes of bleeding were reported by 8/37 (21.6%) patients in the stapled group and 5/37 (13.5%) patients in the Milligan-Morgan group (p = 0.542). No problems related to continence and defecation were reported in either group. Patients were satisfied with the operation in 33/37 (89.2%) cases in the stapled group and 31/37 (83.8%) cases in the Milligan-Morgan group (p = 0.735). Hemorrhoidectomy with a circular staple device is easy to perform and achieves better results than the Milligan-Morgan technique in terms of postoperative pain and recovery. Comparable results are obtained at long-term follow-up.

Adult↗
PubMed2005

Usefulness of lateral internal sphincterotomy in reducing postoperative pain after open hemorrhoidectomy.

The aim of the present study was to evaluate the effect of lateral internal sphincterotomy on pain after open hemorrhoidectomy. From 1998 to 2003, seventy-eight (78) patients with fourth-degree hemorrhoids were included in this prospective randomized trial. The patients were randomized into two equal groups of 39 patients. Patients from group I underwent Milligan-Morgan hemorrhoidectomy. Patients from group II, quite apart from Milligan-Morgan hemorrhoidectomy, underwent lateral internal sphincterotomy up to the dentate line, in the left hemorrhoidectomy wound. One surgeon from the Department, who did not know to which group the patients belonged, evaluated the postoperative course in all the patients. After the first bowel movement, there were three (7.7%) patients who did not experience any pain in the internal sphincterotomy group, while in the non-internal sphincterotomy group all patients experienced mild or moderate pain. There were also more patients who experienced excruciating pain in the non-internal sphincterotomy group than in the internal sphincterotomy group (25 vs. 18); these differences were statistically significant (p = 0.034). There was no significant difference in the Wexner Incontinence Scale between the groups (p = 0.228). The addition of lateral internal sphincterotomy to open hemorrhoidectomy seems to have a positive effect on reducing postoperative pain in a few patients, without affecting the postoperative complications rate.

Adult↗
PubMed2007

Special anoscope for easy purse-string suture application in stapled hemorrhoidopexy.

BACKGROUND: Internal hemorrhoids and loose rectal mucosa may block exposure during the purse-string suturing in stapled hemorrhoidopexy, and this may lead to complications. MATERIALS AND METHODS: To retract the prolapsing rectal mucosa, we modified the purse-string anoscope of the PPH01 kit (Ethicon-Endosurgery, Cincinnati, OH, USA) and produced a special anoscope. The open part of the purse-string suture anoscope is covered by transparent acrylic (Orthoacryl, Dentaurum, Pforzheim, Germany). The covering had completely cylindrical outer and inner surfaces and was thin enough to let the anoscope easily rotate in the anal dilator and to let the 26 mm curved, round-bodied needle of the 2/0 polypropylene suture move in the anoscope. A window, 3 cm long and 3-4 mm wide, was opened at the angled part of the anoscope 2 cm to the tip. This special anoscope was used for the purse-string suture during the stapled hemorrhoidopexy procedure in five patients. RESULTS AND CONCLUSIONS: No postoperative complications, early or late, were encountered, and we propose that stapled hemorrhoidopexy procedure can be applied more easily by using this special anoscope.

Equipment Design↗
PubMed2000

Embolization for gastrointestinal hemorrhages.

Retrospective evaluation of interventional embolization therapy in the treatment of gastrointestinal hemorrhage over a long-term observation period from 1989 to 1997. Included in the study were 35 patients (age range 18-89 years) with gastrointestinal bleeding (GI) referred for radiological intervention either primarily or following unsuccessful endoscopy or surgery. Sources of GI bleeding included gastric and duodenal ulcers (n = 7), diverticula (n = 3), erosion of the intestinal wall secondary to malignancy (n = 6), vascular malformations (n = 4), and hemorrhoids (n = 2), as well as from postoperative (n = 6), posttraumatic (n = 2), postinflammatory (n = 4) or unknown (n = 1) causes. Ethibloc (12 cases) or metal coils (14 cases) were predominantly used as embolisates. In addition, combinations of tissue adhesive and gelfoam particles and of coils and Ethibloc were used (six cases). Finally, polyvinyl alcohol particles, a coated stent, and an arterial wire dissection were utilized in one case each. Bleeding was stopped completely in 29 of 35 cases (83%). In one case (3%) the source of bleeding was recognized but the corresponding vessel could not be catheterized. In five other cases (14%) there was partial success with reduced, though still persistent, bleeding. The rate of complications was 14%, including four instances of intestinal ischemia with fatal outcome in the first years, and, later, one partial infarction of the spleen without serious consequences. Gastrointestinal hemorrhage can be controlled in a high percentage of patients, including the seriously ill and those who had previously undergone surgery, with the use of minimally invasive interventional techniques. The availability of minicoils instead of fluid embolization agents has reduced the risk of serious complications.

Adolescent↗
PubMed2006

Postoperative urinary retention after surgery for benign anorectal disease: potential risk factors and strategy for prevention.

PURPOSE: This study was undertaken to determine the incidence of and risk factors for urinary retention after surgery for benign anorectal disease. METHODS: We reviewed 2,011 consecutive surgeries performed under spinal anesthesia for benign anorectal disease from January through June 2003 to identify potential risk factors for postoperative urinary retention. In addition, we prospectively investigated the preventive effect of perioperative fluid restriction and pain control by prophylactic analgesics on postoperative urinary retention. RESULTS: The number of procedures and the urinary retention rates were as follows: hemorrhoidectomy, 1,243, 21.9%; fistulectomy, 349, 6.3%; incision/drainage, 177, 2.3%; and sliding skin graft/lateral subcutaneous internal sphincterotomy, 64, 17.2%. The overall urinary retention rate was 16.7%. With hemorrhoidectomy, female sex, presence of preoperative urinary symptoms, diabetes mellitus, need for postoperative analgesics, and more than three hemorrhoids resected were independent risk factors for urinary retention as assessed by multivariate analysis. With fistulectomy, female sex, diabetes mellitus, and intravenous fluids >1,000 ml were independent risk factors for urinary retention. Perioperative fluid restriction, including limiting the administration of intravenous fluids, significantly decreased the incidence of urinary retention (7.9 vs 16.7%, P<0.0001). Furthermore, prophylactic analgesic treatment significantly decreased the incidence of urinary retention (7.9 vs 25.6%, P=0.0005). CONCLUSIONS: Urinary retention is a common complication after anorectal surgery. It is linked to several risk factors, including increased intravenous fluids and postoperative pain. Perioperative fluid restriction and adequate pain relief appear to be effective in preventing urinary retention in a significant number of patients after anorectal surgery.

Adult↗
PubMed2006

Stapled vs open hemorrhoidectomy: long-term outcome of a randomized controlled trial.

BACKGROUND AND AIMS: Stapled hemorrhoidectomy is a relatively new procedure, and studies on long-term outcomes are few. We present the results of a 5-year follow-up on patients recruited to a randomized controlled trial comparing stapled and Milligan-Morgan hemorrhoidectomy. PATIENTS AND METHODS: We performed telephone interviews and office visits between May and July 2005 on patients who had taken part in a randomized controlled trial from May 1999 to December 2000. RESULTS: Occasional pain and bleeding were referred by the patients with no difference between the two groups. The patients were also equally satisfied with both procedures. No recurrent hemorrhoidal prolapse or stenosis was detected at anorectal exploration and rigid sigmoidoscopy. CONCLUSION: Both stapled and Milligan-Morgan techniques guarantee satisfactory long-term results. Larger studies are needed to assess the durability of stapled hemorrhoidectomy.

Follow-Up Studies↗