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At least 1,783 records · Page 99Linked to original sources
PubMed2000

Adenocarcinoma in a hemorrhoidectomy specimen: case report and review of the literature.

Our purpose is to report a case of unexpected anal adenocarcinoma found in a hemorrhoidectomy specimen. A review of the literature, with emphasis on extramucosal anal adenocarcinoma as a pathologic entity, is included. Our patient presented with a 2-year history of grade III prolapsing internal hemorrhoids. A hemorrhoidectomy was performed and gross examination of the specimen was unremarkable. The pathologic evaluation revealed microinvasive well-differentiated adenocarcinoma at the squamocolumnar junction. There was neither an apparent connection with the overlying mucosa nor an in situ component. A metastatic workup ruled out any other site of malignancy. At follow-up 18 months after surgery, no evidence of malignancy or recurrence was observed. An unexpected extramucosal anal adenocarcinoma in a hemorrhoidectomy specimen is a very exceptional finding. Review of the literature does not support routine histopathological examination of hemorrhoidectomy specimens.

Adenocarcinoma↗
PubMed2000

[Day surgery for anal disease].

Historically, patients with anal diseases treated on a day surgery basis had inadequate cure rates and a high complication rate. After World War II, modern treatment methods were learned from the UK and USA and improved in Japan. However, the improved radical methods were so complex that approximately 2 weeks' hospitalization was needed. Recently, day surgery for various diseases including hemorrhoids has been recommended by the Japanese ministry of Health and Welfare. However, the characteristics of anal anatomy and physiology make the smooth healing of wounds difficult and tend to cause postoperative pain, bleeding, infection, prolonged healing time, etc. To prevent such difficulties, care must be well planned following the critical path of informed consent, careful surgery, postoperative observation, and management at home. However, hospital staff in charge of such surgery are under so much stress that only patients with less severe anal disease without local or systemic complications should be selected for day surgery.

Ambulatory Surgical Procedures↗
PubMed2001

[Ambulatory surgical interventions in patients with proctological diseases].

The results of 629 operations for the most frequent proctological diseases (hemorrhoid, anal scissure, rectal fistula, acute paraproctitis) were analyzed. 134 operations were performed in outpatient clinic, 225--in one-day hospital and 270 (control group)--in coloproctology department. The place of operation did not influence postoperative period and temporary disability time. The mean stay of patient in outpatient department and hospital surgical unit was 3.8 and 324 hours, respectively. Since the second day after operation in specialized department it is possible to perform therapeutic manipulations outpatient in coloproctology room without negative sequences for patient's health. Cost of the ambulatory operation constituted 28.4% of hospital stay for patients with similar interventions. Surgical treatment of the above diseases could be performed in outpatients setfing in more than 50% patients. The bed resources must be used for patients who need long-term and intensive treatment in specialized department.

Ambulatory Surgical Procedures↗
PubMed2001

Common anorectal conditions: Part II. Lesions.

Patients with a wide variety of anorectal lesions present to family physicians. Most can be successfully managed in the office setting. A high index of suspicion for cancer should be maintained and all patients should be questioned about relevant family history or other indications for cancer screening. Patients with condylomata acuminata must be examined for human papillomavirus infection elsewhere after treatment of the presenting lesions. Their sexual partners should also be counseled and screened. Both surgical and nonsurgical treatments are available for the pain of anal fissure. Infection in the anorectal area may present as different types of abscesses, cryptitis, fistulae or perineal sepsis. Fistulae may result from localized infection or indicate inflammatory bowel disease. Protrusion of tissue through the anus may be due to hemorrhoids, mucosal prolapse, polyps or other lesions.

Abscess↗
PubMed1999

[Analysis in pulmonary ventilatory function from 100 patients with ano-rectal diseases caused by deficiency of qi].

OBJECTIVE: To explore the pathogenesis of ano-rectal diseases caused by deficiency of Qi, which is correlated with obstruction of pulmonary ventilation. METHODS: The pulmonary ventilatory function was measured in 100 patients with the internal piles, the interno-external hemorrhoid and prolapse of rectum, the prolapse of anus was the principal symptom of them. RESULTS: Data from the 100 patients showed that 67% of them were diagnosed with the obstruction of pulmonary ventilation, the ratio was far less in the health control group. FEV 1.0 (mean +/- s) (2011.65 +/- 875) ml, MMF (1.84 +/- 1.24) L/s and PEF (2.34 +/- 1.51) L/s in male patients, (1551.54 +/- 514) ml, (1.57 +/- 0.62) L/s and (1.85 +/- 0.92) L/s in female patients, but those values were higher in the control than in the patients. The statistical analysis was performed and the difference was significant between patients and the control group (P < 0.01). CONCLUSION: The patients with ano-rectal diseases caused by deficiency of Qi accompanied with obstruction of pulmonary ventilation in different degree and varied sorts, it confirmed that the pathogenesis of ano-rectal diseases caused by deficiency of Qi is related with "sinking of pectoral Qi".

Adolescent↗
PubMed2001

Cryosurgical ablation for prostate cancer: preliminary results of a new advanced technique.

BACKGROUND: Cryosurgery is a minimally invasive treatment option for prostate cancer. OBJECTIVES: To report on the first series of cryosurgical ablation for prostate cancer performed in Israel. METHODS: Cryosurgical ablation of the prostate was undertaken in 12 patients aged 53-72 diagnosed with adenocarcinoma of the prostate. The procedures were performed percutaneously and were monitored by real-time trans-rectal ultrasound. The CRYOHIT machine applying Argon gas was used with standard or ultra-thin cryoprobes. The average follow-up was 12.8 months postsurgery (range 1-24 months). RESULTS: No rectal or urethral injuries occurred and all patients were discharged from hospital within 24-48 hours. The duration of suprapubic drainage was 14 days in 10 patients and prolonged in 2. Early complications included penoscrotal edema in four patients, perineal hematoma in three, hemorrhoids in two and epidydimitis in one. Long-term complications included extensive prostatic sloughing in one patient and a perineal fistula in another, both of whom required prolonged suprapubic drainage. Minimal stress incontinence was noted in two patients for the first 8 weeks after surgery. None of the patients has yet regained spontaneous potency. A prostate-specific antigen nadir of less than 0.5 ng/ml was achieved in eight patients and an undetectable PSA level below 0.1 ng/ml in five patients. CONCLUSION: Cryoablation for prostate cancer is safe and feasible, and the preliminary results are encouraging. Further study is needed to elucidate the efficacy of the procedure.

Adenocarcinoma↗
PubMed2000

[Study on lumbricus in promoting ligation hemorrhoidectomy postoperative wound healing].

OBJECTIVE: To investigate the effect of Lumbricus in promoting wound healing of ligation hemorrhoidectomy. METHODS: Spray the artificial grown fresh Lumbricus solution on the wound surface of the mixed hemorrhoid patients (treated group) after hemorrhoidectomy and also on wound of the experimental animals, and Lithospermum erythrorhizon medicated gauze was taken as control to observe the effect of treatment on wound healing and histologic change. RESULTS: The mean wound healing time of the treated group was 16.5 +/- 1.8 days, as compared to the control group (21.2 +/- 2.8 days), it was obviously shortened (P < 0.01), 3 days after medication, the growth of epidermis of the treated group was obviously more rapid than that of the control group, no wound infection and granulation hyperplasia were found. The experimental study showed that Lumbricus preparation could inhibit inflammation, bacteria such as Staphylococcus aureus, coli and proteus bacillus was inhibited. In comparison with the control group, the experimental group shortened the healing period for 4 days. On the 4th and 7th day, sacrificed rabbits' capillary count, vessel lumen endothelial cell count, and mesenchymal fibroblast count of the experimental group grower obviously than those of the control group, on the 4th day, the mesenchymal cell mitosis of the experimental group was higher than that of the control group, while on the 7th day, the cell nucleus mitotic index in the experimental group also was higher than that in the control group, from the 3rd day on, wound healing and granulation filling speed of the experimental group obviously more rapid than that of the control group. CONCLUSION: The Lumbricus preparation is cheap in price, easy to preserve, can be used in promoting wound healing, without any toxic and side-effects.

Adult↗
PubMed1975

[Anorectal symptom complex in zoster sacralis].

Disorder by hemorrhoids can occasionally be caused by sacral herpes zoster. Only exact local inspection in connection with the anamnestic statement of neuralgic pain as well as hurting sensations of the rectum leads to the proper diagnosis.

Aged↗
PubMed2002

Use of enzyme and heparin paste in acute haemorrhoids.

BACKGROUND: While treating acutely inflammed piles, surgeons in general prefer to stick to the conservative method of treatment. This includes bed rest in a Trendelenburg's or jack-knife position, administration of liquid diet, stool softeners, antibiotics, and anti-inflammatory drugs along with warm Sitz baths and local application of glycerin and magnesium sulphate paste. We introduced an additional method in treating acutely inflammed piles. Ten tablets of trypsin and chymotrypsin (Chymoral forte, Elder Pharmaceuticals India) were powdered and were mixed with 30 grams of heparin (Thrombophobe, German Remedies Ltd, Germany) ointment. This paste was applied to the inflammed pile mass. In all, 67 received this in patient treatment with an average hospital stay of 2 days. The results were compared using chi2 test with similarly placed 22 patients who were treated with the conventional method only. RESULTS: In the patients receiving the application of the enzyme paste, local pain was reduced to a great extent, the defecation was comfortable, there was negligible local pruritus, and the routine body movements of the patient were painless. Local signs observed in the form of the size of the piles, perianal edema, and tenderness, were also found to be significantly reduced. CONCLUSION: The results of this study demonstrate that the additional use of a heparin-enzyme paste applied directly over the pile masses significantly improves the healing and resolution of acutely inflammed hemorrhoids. The effectiveness of the traditional conservative method of treatment could be gainfully supplemented by use of the pharmaceutical preparation suggested in this study.

Administration, Topical↗
PubMed1992

[The use of methyldioxyline for the prevention of local complications following hemorrhoidectomy].

The article discusses the results of clinico-laboratory study of the application of methyl dioxyline ointment after hemorrhoidectomy with complete restoration of the anal canal mucosa. It is shown that the ointment is a reliable measure for the prevention of postoperative purulent complications, it improves the reparative processes. Its use in the treatment of wounds developing as the result of excision of hemorrhoids shortens the term of in-patient treatment after the operation and the period of general incapacity.

Anti-Infective Agents↗
PubMedDate not supplied

[Milligan-Morgan haemorrhoidectomy with ultrasonic scalpel].

INTRODUCTION: Milligan-Morgan haemorrhoidectomy is considered the best treatment for hemorrhoidal disease. Although this, many patients complaint post-operative pain that remain the worse complication. For this reason different are the trials performed in order to reduce his intensity. In this report we want to evaluate if the use of ultrasonic scalpel to perform Milligan-Morgan hemorrhoidectomy, compared with conventional surgery, could reduce post-operative pain. MATERIALS AND METHODS: 30 patients with III and IV degree of haemorrhoids were included in this study and divided in two groups. In the first group Milligan-Morgan haemorrhoidectomy was performed with conventional instruments, while in the second group the some procedure was performed with ultrasonic scalpel. The duration of intervention, time hospitalization, the time to open alvus to stools, the time to return to normal activity, the complications, pain and the amount of analgesic consumption were evaluated. RESULTS: In the II group's patients, it was observed a reduced time to healing with reduced spread of necrosis and inflammatory pattern, associated with reduced post-operative pain and the lower analgesic consumption. CONCLUSIONS: The use of ultrasonic scalpel to perform Milligan-Morgan haemorrhoidectomy, compared with conventional instruments, reduce post-operative pain making a more short time to healing and a precocious time to return to normal activity. For this reason we believe that the use of ultrasonic scalpel, although a more elevated costs, seems to be advantageous.

Adult↗
PubMedDate not supplied

[PATE 2000 Sorrento: a modern, effective instrument for defining haemorrhoids. A multicentre observational study conducted in 930 symptomatic patients].

In 2000, the Italian Society of Coloproctology and the UCP (Coloproctology Units) devised a new haemorrhoid classification system, named PATE 2000 Sorrento, which is capable of defining all the main characteristics of the disease. Any new system should be able to predict the real extent of hemorrhoids by means of a specific index in order to help physicians in choosing the best therapeutic option. The authors present the results of a national multicentre study of 930 patients with symptomatic haemorrhoids. Nineteen patients (2%) could not be classified with the old haemorrhoid classification, while PATE 2000 Sorrento proved successful in classifying all patients. The difference was statistically significant. The new classification enables us to establish a specific score for the disease. In order to better evaluate the clinical impact of the scores obtained with PATE 2000 Sorrento, the authors analyzed the correlation between the score itself and the therapy chosen by each individual centre. The highest scores always corresponded to the choice of surgical hemorrhoidectomy, while in the case of lower values each centre seemed to be in doubt between medical therapy and other less invasive procedure such as sclerotherapy or rubber band ligation. These data were statistically significant (P < 0.0001). On the basis of our findings, PATE 2000 Sorrento seems to confirm its scientific and clinical relevance and could be a useful tool for the choice of the best treatment for each individual patient.

Adolescent↗
PubMed2004

The needling technique and clinical application of point Zhibian.

Point Zhibian (BL 54) is often used for treatment of lumbago and scelalgia, flaccidity and arthralgia of the lower limb, constipation and dysuria, and hemorrhoid. As for the needling, the direction of the needle tip may vary, generally in three directions: 1) along the channel itself, 2) pointing to the genitals, and 3) pointing to the anus, the purpose of which is "leading qi to the diseased area" so as to obtain "effectiveness upon the arrival of qi". This point can also be used in combination with moxa stick, cupping, and point injection according to the individual conditions. However, only by differential application, can this point produce better therapeutic effects.

Acupuncture Points↗
PubMed2004

Consider colonoscopy for young patients with hematochezia.

BACKGROUND: Hematochezia is a common complaint in adult patients aged <50 years. Most studies of lower endoscopy for rectal bleeding have concentrated on older patients or have failed to mention the location of lesions. OBJECTIVE: To determine the findings of complete colonoscopy in adults younger than 50 years with rectal bleeding. METHODS: Data were retrieved from medical records and included demographics, indications, endoscopic findings, and histology. Lesions were labeled according to location: proximal to the splenic flexure or distal to (and including) the splenic flexure. Excluded were those with a history of colitis, colorectal cancer, polyps, anemia, significant weight loss, severe bleeding, or strong family history of colorectal cancer. RESULTS: The study included 223 patients with rectal bleeding aged <50 years who had undergone a colonoscopy. Normal findings were recorded for 48 (21.5%). Four (1.8%) were diagnosed with cancer in the distal colon, and 22 (9.9%) were found to have colon adenomas, 6 of whom had proximal adenomas only. Hemorrhoids were present in 135 patients (60.5%). Other findings included colitis, angiodysplasia, diverticulosis, anal fissures, and rectal ulcers. CONCLUSIONS: Colon neoplasms may be present even in younger adults with nonurgent rectal bleeding. Though most findings were benign and located in the distal colon, colonoscopy should be strongly considered for this patient group.

Adenoma↗
PubMedDate not supplied

[Doppler-guided transanal haemorrhoidal dearterialisation].

The usual surgical treatment for haemorrhoids consists in excision of the piles and ligation of the hemorrhoidal plexus, with considerable postoperative pain. A new, less invasive technique has been introduced, called transanal haemorrhoidal dearterialisation. This technique consists in Doppler-guided ligation of the distal branches of the superior rectal arteries (3 to 6) 2-3 cm above the pectinate line. Arterial ligation causes reduction of blood flow to, and decongestion of, the haemorrhoidal plexus. From January 2000 to September 2003, we performed transanal haemorrhoidal dearterialisation in 138 patients. Patients experienced no pain in the immediate postoperative period. The follow-up revealed good outcomes. The transanal haemorrhoidal dearterialisation procedure can be considered a safe, effective, painless and quick method of curing haemorrhoidal disease. Its indications are extensive. The success rate is approximately 90%, but may be lower for grade 4 haemorrhoids.

Anal Canal↗
PubMedDate not supplied

[Transfixed stitches for the treatment of haemorrhoids].

Nowadays the proctologist has the opportunity to perform various different surgical techniques for the treatment of hemorrhoids. Circumferential mucosectomy with a stapler, diathermic hemorrhoidectomy with high frequency devices, and the HLA doppler II system have significantly modified the classical indications for the treatment of the disease. There is, however, still no general consensus as to the indications for the use of each of these techniques in clinical practice, giving rise to confusion among specialists and an inappropriate use of health care resources. For these reasons the authors propose a new technique for the treatment of haemorrhoids based upon a new classification system, named PATE 2000 Sorrento. The transfixed correction of haemorrhoids makes it possible to treat third degree internal piles in association with the Milligan-Morgan procedure for fourth degree piles in a simple, definitive and safe session. This technique seems to offer a valid alternative to stapled hemorrhoidectomy, on the one hand, and classical open or closed hemorrhoidectomy combined with rubber band ligation, on the other. The authors describe the technical feasibility of their technique and underline the good clinical results obtained in their initial experience with 20 consecutive patients.

Adult↗
PubMedDate not supplied

Manometric study of the anal sphincter during haemorrhoidectomy using posterior perineal block.

Minor anorectal diseases affect 4-5% of the adult western population. Operations are performed on an ambulatory or 24-hour-stay basis. The aim of our study was to assess the physiology of anal sphincter relaxation by anal manometry after posterior perineal block during haemorrhoidectomy. We recruited 15 patients with third and fourth degree hemorrhoids in a manometric study of the anal sphincter during haemorrhoidectomy with regional anaesthesia. The patients underwent anal manometry before and 15 minutes after the posterior perineal block to determine the resting and squeeze anal pressures. Differences were considered significant at p < 0.05. We observed mean reductions of 34.6% and 37.1% in resting and squeeze pressure values, respectively, after posterior perineal block (p < 0.005). Our manometric study demonstrated that anal sphincter relaxation after posterior perineal block correlates with a significant reduction in resting and squeeze pressures because the block anaesthesia not only the somatic, but also the sympathetic fibres. We believe that posterior perineal block allows the surgeon to perform radical haemorrhoidectomy in the overnight stay setting with optimal intra- and postoperative analgesia, safe sphincter relaxation, lower postoperative complications, and lower costs to the public health service.

Adult↗
PubMed2005

[Butcher's Broom, in the treatment of venous insufficiency].

Numerous extracts of the plants, natural compounds and their derivatives, acting on the venous system, including horse-chestnut seed extracts aescin, rutin, troxerutin, diosmin and hesperidine. They have a long tradition in herbal medicine for their venotonic and anti-oedematous properties. This review is concerning Rusci aculeati rhizoma, which recently taken in Poland on the symptoms of chronic venous insufficiency and hemorrhoids.

Chronic Disease↗